Colorectal Cancer Screening

Why is this important?

Nearly everyone should have a colon cancer screening beginning at age 45. When colon cancer is caught early, it is easier to treat. Screening can also prevent colon cancer from occurring by removing small growths called polyps before they become cancerous. A screening test can find cancer when there are no symptoms. Screening guidelines have recently changed, so not everyone is aware of when they should begin getting screened for colorectal cancer. HealthPartners looked at our data and saw that people who don’t have a primary care clinic have lower screening rates than those who have a regular health care provider. While there are a few screening tests for colorectal cancer, this project uses fecal immunochemical test kit, also known as a FIT kit, an in-home test kit that screens for the presence of blood the stool, which can be an early indication of colorectal cancer.

What did we do?

We wanted to create a high-quality program and have real time access to data, so we worked with HealthPartners Central Lab and our online care provider Virtuwell to create an end-to-end process to provide the service and meet the needs of our members. We launched the first iteration of the program in 2021.

We looked at our data and identified members who were due for a colon cancer screening.

1. Eligible members will receive an e-mail from Virtuwell inviting them to order a kit.
2. Central Lab mails the kit to the member, the member completes the kit, and mails it back to our Central Lab for processing.
3. And then once processed, the member receives their results from a Virtuwell clinician.

What challenges did we face?

In 2022, we identified that a lot of members were ordering a FIT kit but not returning it. We conducted one-on-one interviews with members to understand why a member might not return the kit after requesting it. Through these interviews, we learned two primary reasons that people were not returning the FIT kits:

• Members would receive the kit but not recognize that it was the FIT kit because the envelope was generic or they thought it was junk mail; OR
• The member knew that it was their FIT kit, but they were not in a rush to complete it and return because they did not know that the kit had an expiration date.

Understanding these barriers, language was added on the outside of the kit envelopes to call out that the contents are time sensitive while still maintaining member privacy. With this change, our return rate increased from 53.1% in 2022 to 67.4% in 2023.

Results

Through in-house automation, we have been able to deliver a sustainable, high-quality, and highly reliable colon cancer screening process to our members. Year-over-year, we have been able to increase our outreach and the number of FIT kits sent, without impacting the resources needed. In 2023, we shipped over 4,500 kits and had more than 3,000 of those kits returned to us by members. Our Central Lab team was able to send out a kit to a member, on average, in just half of a day after receiving the kit request and was then able to process the kit in less than a day’s time once receiving the completed kit back.

Additionally, we are finding that members are very satisfied with the FIT kit experience, especially as our consumer base moves to wanting a more hybrid approach to care that is still reliable and personable. We have heard from our members numerous times that our program is easy, fast, and efficient to participate in. They also feel that FIT kits provide a convenient way to screen for colorectal cancer that results in comprehensive but easy to understand test findings and recommended next steps.

Ongoing work

HealthPartners is committed to encouraging our members to receive routine colorectal cancer screening starting at the age of 45. We will continue to send screening reminders to members when they are due as well as offer the option of a FIT kit for colorectal screening to those members that it is appropriate for.