A HealthPartners Institute study involving Essentia Health will assess whether a clinical decision support tool in electronic medical records called the "Cancer Prevention Wizard" can increase preventive cancer care in rural areas.
The Cancer Prevention Wizard (CP Wizard) helps primary care physicians identify patients, ages 11 to 80, who are not up to date on recommended cancer prevention services. It also provides them with evidence-based recommendations for primary and secondary cancer prevention. Primary cancer prevention will include smoking cessation, body weight management and human papilloma virus (HPV) vaccination. Secondary cancer prevention will include screening tests for colorectal, breast, cervical and lung cancer, according to U.S. Preventive Services Task Force guidelines.
The five-year study will involve more than 150,000 patients who receive care at 30 Essentia Health primary care clinics in northern Minnesota, northwestern Wisconsin and eastern North Dakota. Using a cluster-randomized trial design, the study will compare three groups of clinics. In one group, primary care physicians will use the tool to identify and offer prevention services to their patients. In a second group, certified medical assistants will use the tool and discuss screening and prevention options with patients before they see their doctors. The third group includes clinics where patients will get usual care that has no cancer prevention activities promoted by the CP Wizard.
In addition, the CP Wizard will personalize recommendations by determining each patient’s unique characteristics and using special cancer-risk assessment tools from the National Cancer Institute.
Researchers will assess whether use of the CP Wizard results in more patients receiving recommendations for cancer preventive services and whether certified medical assistants have an effect on patient outcomes. The study will also evaluate whether use of the CP Wizard results in higher short-term health care costs but lower long-term costs compared to clinics that do not use the tool.
“This tool will create a patient’s risk profile for cancer and display it in one place so that the clinician and the patient can engage in a shared decision-making discussion to create a plan for primary prevention of cancer and cancer screening," says Dr. Joe Bianco, Essentia's co-investigator on the study. "The rapid collection of the data creates efficiency for a busy clinician and how it displays this data for the patient will lead to better patient engagement."
The research is supported by a $3 million grant from the National Cancer Institute of the National Institutes of Health. It is the third partnership between HealthPartners and Essentia Health to use clinical decision support tools in electronic medical records to provide evidence-based guidelines in the exam room to improve care.
Other decision support tools being studied include providing current recommendations to reduce cardiovascular risk in patients with serious mental illness, and identifying patients that have pre-diabetes who are at risk of developing diabetes if left untreated. According to the Agency for Healthcare Research and Quality, rural residents have fewer visits to health care providers and are less likely to receive recommended preventive services including cancer prevention and management of cardiovascular disease and diabetes.