In:
Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 30, No. 34_suppl ( 2012-12-01), p. 292-292
Kurzfassung:
292 Background: Follow-up of laboratory results is challenging in outpatient care, and research indicates an electronic health record (EHR) alone is insufficient to ensure appropriate follow-up of abnormal results. Methods: In April 2006, Kaiser Permanente Southern California implemented a Prostate-Specific Antigen (PSA) Safety Net to detect men with elevated serum PSA levels who had not yet received follow-up care at 6 months post-testing. The PSA Safety Net scanned the EHR to identify men age 45-79 with elevated PSA values. Men were then excluded if they had a prior prostate cancer diagnosis or evidence of follow-up care within 6 months of the PSA test, defined as any of the following: a subsequent visit with a urologist or oncologist, normal PSA value, biopsy, or prostate cancer diagnosis. In June 2009, the criterion for follow-up care was reduced from 6 to 3 months. The electronic Safety Net tool was refreshed daily, stored key data (e.g., contact information), and recorded actions of care managers (e.g., expedited appointment scheduled). We evaluated how many men were identified through the PSA Safety Net and whether they were systematically different from men followed through routine care. Results: From 4/2006-12/2010, 45,762 men had an elevated serum PSA level. Twenty percent (n=9,373) were identified through the PSA Safety Net. Of 7,729 prostate cancers diagnosed, 9.6% (n=739) were found through the PSA Safety Net. Age, race/ethnicity, and language preference was similar among men followed through the Safety Net vs. routine care. Men followed through the PSA Safety Net were less likely to be enrolled in kp.org (46% vs. 54% respectively, p 〈 0.001), which provides online access to lab results. Median PSA levels were slightly lower among those followed through the PSA Safety Net. Men in the Safety Net also were less likely to be diagnosed with Stage IV cancers than men followed via routine care (2.8% vs. 5.5%, p=0.002), although stage was similar overall. Conclusions: Within a health system using an advanced EHR, a substantial number of men with elevated PSA levels were identified and managed through a PSA Safety Net. These men were largely similar to those followed through routine care, although tended toward lower risk.
Materialart:
Online-Ressource
ISSN:
0732-183X
,
1527-7755
DOI:
10.1200/jco.2012.30.34_suppl.292
Sprache:
Englisch
Verlag:
American Society of Clinical Oncology (ASCO)
Publikationsdatum:
2012
ZDB Id:
2005181-5
