Colonoscopy Screening: Setting Epic Follow-up Times

NCT05631873 | Completed

• 1 other identifier: 2022P001436
• Study Type: interventional
• Target: 43
• Locations: 1 country
• Sites: 1

Brief Summary

Screening for colorectal cancer can reduce its incidence and mortality but is a complex, error-prone process. The value of screening with colonoscopy is in removing pre-cancerous polyps that increase one's risk for future cancer. Abnormal results are common, and failure to receive recommended follow-up undermines the benefits of screening, violates the trust that patients place in their providers, and increases medicolegal risk. This proposal seeks to ensure that the foundation of safety systems, the recommendations for the follow-up interval reflect current guideline recommendations and are accurately updated. Specifically, the investigators will implement and evaluate in a randomized trial a new colonoscopy result letter as part of usual care that automatically updates the recommended follow-up interval in the patient's health record compared to the current result letter format.

Conditions

Concordance Between Colonoscopy Follow up Interval Noted in Patient Letters vs. Electronic Health Record Chart; Colorectal Cancer

Outcome Measures

Primary Outcomes (2)

• Implement a new process using a structured result letter template to set the electronic health record follow-up interval after a screening colonoscopy.

  Provider level: any use (yes/no) of the structured result template letter among all randomized providers

  6 months

• Implement a new process using a structured result letter template to set the electronic health record follow-up interval after a screening colonoscopy.

  Patient level: agreement (yes/no) will be assessed between the follow-up interval specified in the patient result letter and the colonoscopy health maintenance topic modifier

  6 months

Study Arms (2)

Intervention

EXPERIMENTAL

Other: Assistance with implementing Epic Smartlist

Control

NO INTERVENTION

Interventions

Assistance with implementing Epic Smartlist OTHER

A research assistant helps GI providers add a new SmartList in to patient letters in Epic EHR that auto populates the colonoscopy recommendation time interval in patient records

Intervention

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• GI specialists will include those who perform screening and surveillance colonoscopies for colorectal cancer screening at MGH

You may not qualify if:

• Not currently performing colonoscopies

Sponsors & Collaborators

• Massachusetts General Hospital: lead
• Harvard Risk Management Foundation: collaborator

Study Sites (1)

Massachusetts General Hospital

Boston, Massachusetts, 02114, United States

Location

Related Publications (1)

• Atlas SJ, Palchaudhuri S, Harris KA, Gallagher KL, He W, Rubins D, Chang Y, Haas JS, Richter JM. A Randomized Controlled Trial to Improve the Accuracy of Follow-Up Surveillance Time Intervals in the Electronic Health Record After a Colonoscopy for Colorectal Cancer Screening. Am J Gastroenterol. 2025 Apr 23. doi: 10.14309/ajg.0000000000003497. Online ahead of print.

  PMID: 40267265 DERIVED

MeSH Terms

Conditions

Colorectal Neoplasms

Interventions

Insemination, Artificial, Heterologous

Condition Hierarchy (Ancestors)

Intestinal Neoplasms; Gastrointestinal Neoplasms; Digestive System Neoplasms; Neoplasms by Site; Neoplasms; Digestive System Diseases; Gastrointestinal Diseases; Colonic Diseases; Intestinal Diseases; Rectal Diseases

Intervention Hierarchy (Ancestors)

Insemination, Artificial; Reproductive Techniques, Assisted; Reproductive Techniques; Therapeutics; Investigative Techniques; Insemination; Reproduction; Reproductive Physiological Phenomena; Reproductive and Urinary Physiological Phenomena

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor of Medicine, Harvard Medical School; Director of the Practice-Based Research & Quality Improvement Network

Study Record Dates

• First Submitted: November 18, 2022
• First Posted: November 30, 2022
• Study Start: November 18, 2022
• Primary Completion: September 30, 2023
• Study Completion: March 11, 2024
• Last Updated: March 12, 2024

Record last verified: 2024-03

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)