Screening for Bowel Cancer Disease

1. Introduction

Bowel Cancer Disease is managed by several features of the DCP including Clinical Prompts (mainly FOBT), as well in Patient Centric Documents and Taskflows.

2. Background

2.1 Screening Participation in the Population

According to the National Bowel Cancer Screening Program: monitoring report 2016, for participation:

"Of the 2.2 million people invited between January 2013 and December 2014, 37% participated in the program. The national participation rate was slightly higher than the previous rolling 2-year period (2012-2013) (36%). The re-participation rate for people who had taken part in an earlier invitation round and were receiving a subsequent screening invitation was 74%."

The Screening results were: "In 2014, about 35,000 Australians returned a positive screening test, giving a 7% screening positivity rate."

It was summarised that: "One in 32 participants who underwent a follow-up diagnostic assessment were diagnosed with a confirmed or suspected cancer."

2.2 How it is Recorded Clinically

Manually, the result in the clinical software where the patient declares as such during the consultation. It is actually a new pathology result which is a test result. It does not identify the test result in such (i.e. positive or negative) a way that is can filtered within a DCP taskflow, although it will identity that a test has taken place. The result of that test is be view as text by opening up the relevant clinical indicator prompt (i.e. Colonoscopy or FOBT) from the Main Control Panel.

Any relevant scanned document/s have their result declared in the past history, as a diagnosis. This diagnosis can identify as a filter item in the DCP taskflows.

3. Benchmarks

3.1 Bowel Cancer Screening Rates

The only benchmark we can measure clinical performance by is the screening rate. We can use the DCP taskflows for this, Title "Bowel Cancer Screening 50yoTo75yo - OF".

Inclusion Criteria

    - All patients between 50 to 75 years of age

    Exclusion Criteria

      - a current or previous diagnosis of Bowel Cancer
      - or FOBT (includes colonsocopy result) that has been done in the past 2 years
         - recorded in the clinical software record field,
         - a Colonoscopy Report Result Letter depends on how the practice scans it and either Secure Messaging Inbox or scanned document.
      - these could be made into a DCP Taskflow Exclusion Reason:
         - has refused to have the test/s
         - or terminal ill
         - or those patients who are deemed not indicated by their GP

      Alternatively, you can use PenCAT to view the incidence of this:

      Download PDF File

      4. Self-Learning Resources

      4.1 Video Guides

      All video guides have been compiled into a single YouTube Playlist.

      Watch YouTube Playlist

      These video updates are intended to be a 2-3 minutes brief tour of any new features or improvements added. They are published approximately monthly, and are listed in the following table:

      Name Description Video Date
      Waiting Room Auto-Print Bowel Cancer Screening - Overview for February 2017 An outline of what is required to be done to activate Waiting Room Information Sheets for Patients, and show an example of one.
      Presentation Aims:
      • Setting the Waiting Room Application
      • Describing the Filter and printing Trigger
      • Showing the Information Sheet
      • Adding Windows Desktop Shortcut and Automatic Computer Startup
      YouTube Video 6-Feb-2017
      DCP JLF Integration - Overview for November 2016 This will show you some new features in the Doctors Control Panel software that can help you to improve screening for bowel cancer in your practice.

      The problem that we are trying to solve is that only about one third of people who receive a bowel cancer screening kit from the National Bowel Cancer Screening Program actually use the kit.
      YouTube Video 7-Dec-2016




      4.2 Document Guides

      The following document guides are listed in the following table. Some might be related to each other where a video guide has a matching document guide which could contain for detail.

      Name Description Document Video Date
      Waiting Room Information Sheet Automatic Printing This Promotional Brochure aims to present an overview of the Waiting Room Information Sheet automatic printing feature of the Doctors Control Panel.

      (Use this command to add the desktop shortcut to start)
      shell:common startup

      There are 2 types of waiting room letter information sheets you could present to your patient, whose samples are following:
      PDF File YouTube Video 4-Mar-2017

      1 - Discuss in consultation PDF File
      4-Mar-2017

      2 - Make appointment PDF File
      4-Mar-2017





      5. Training

      Training events and resources to be added later.

      The following document is a mockup of a Colouring Book, a self paced tutorial document for DCP users to complete as part of their formal training of the software, separated by major topics like this Bowel Cancer.

      Download Colouring Book Mockup Sample

      6. FAQ

      Frequently Asked Questions are shown in topical sections following. These are simple questions answered typically in 1-2 paragraphs. If it is more complex and lengthy, refer to the Knowledge Base Articles in the major section following this.

      Clinical Referencing from within the DCP

      Q: How is the colonoscopy test identified in the DCP waiting room feature?

      A: It searches for a letter added to the patient's record in the Clinical software’s Pathology Inbox.
      It typically is a scanned letter from the Gastroenrologist that is identified by the DCP but diagnosis is not. If there was Bowel Cancer discovered the GP would enter this as a diagnosis.

      Q: Does the notification of the FOBT test done through the Government Supplied Kit get updated in the clinical software or the DCP? If so How?
      A: This only happens if:
         1. the Patient nominates the GP, and
         2. that GP receives the result in their Pathology Inbox or a letter added to the patient's record in the Clinical software.

      7. Knowledge Base Articles

      7.1 Technical and Clinical Questions with Known Solutions

      The following document guides are listed in the following table. Some might be related to each other where a video guide has a matching document guide which could contain for detail.

      Name Description Document Video Date
      Bowel Cancer Management using the DCP FAQ This Reference Guide aims to present a series of Frequently Asked Questions (in long form) on Bowel Cancer Management using the DCP. As its a FAQ document, it is likely to be updated regularly. PDF File
      14-Mar-2017






      8. Links

      These are links to other webpages related to this topic.

      8.1 DCP Related

      Name Description and Significance
      URL









      8.2 External Links

      Name Description and Significance URL
      National Bowel Cancer Screening Program The program's Home Page. http://www.cancerscreening.gov.au/internet/screening/publishing.nsf/Content/bowel-screening-1
      Trust Your Gut Trust your Gut is a new campaign by the Jodi Lee Foundation about Bowel Cancer Screening. http://jodileefoundation.org.au/bowel-cancer/initiatives/trust-your-gut
      About bowel screening Bowel screening involves testing for bowel cancer in people who do not have any obvious symptoms of the disease. (...) A screening test called a Faecal Occult Blood Test (FOBT) is used... http://www.health.gov.au/internet/screening/publishing.nsf/Content/about-bowel-screening
      Early Detection, Screening and Surveillance for Bowel Cancer
      In the clinical guideline ‘Early Detection, Screening and Surveillance for Bowel Cancer’, fourth edition 2009, reprinted 2013, published by the Gastroenterological Society of Australia and the Digestive Health Foundation, table 4 advises that asymptomatic people at average risk based on family history should have an FOBT test every two years:
      http://membes.gesa.org.au/membes/files/Clinical%20Guidelines%20and%20Updates/Bowel_Cancer.pdf
      National Bowel Cancer Screening Program: monitoring report 2016 This report presents statistics on the National Bowel Cancer Screening Program (NBCSP). This monitoring report is the first to measure the NBCSP using NBCSP key performance indicators. http://www.aihw.gov.au/publication-detail/?id=60129555866&tab=2
      National Bowel Cancer Screening Program - Fact sheet Information about bowel cancer and the National Bowel Cancer Screening Program http://www.cancerscreening.gov.au/internet/screening/publishing.nsf/Content/nbcsp-fact-sheet
      Providing “Just-in-Time” Preventive Care Advice An article in the Annus of Family Medicine Journal, May/June 2017 Issue, that summarises the concept of the Information Sheet given to patients upon arrival at their General Practice. http://www.annfammed.org/content/15/3/276.full







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