Cancer Screening for our patients

At JS Free Clinic we are able to provide affordable recommended  screening to our patients for some but not all of the preventive measures recommended by the USPSTF (United States Preventive Services Task Force).
http://www.ahrq.gov/clinic/pocketgd1011/

In this post I will review cancer screening we are able to provide to our patients and how we order them. In  future posts I will focus on other types of screening and preventive measures. For all tests I am discussing recommendations for patients with no special or increased risks. 

Colon cancer--We cannot obtain free colonoscopy for our patients. Colonoscopy is expensive, however annual  Fecal Occult Blood Test (FOBT) immunoassay done annually is inexpensive and is another recommended way to screen patients.

 For patients 50 years and older , order FOBT by checking the box on the exit sheet and asking a rooming assistant to instruct the patient in how to use the kit. The age at which to stop screening is less clearly defined but consider discontinuation when the life expectancy is less than 10 yrs or after 75 years of age.

Cervical Cancer--We send specimen for Thin Prep Pap with reflex HPV to Reston Hospital at no cost to our patients. The current recommendations are to start pap tests at age 21, and repeat every 3 yrs; Pap testing can be discontinued after age 65 years. For patients who have never had pap testing and who are older than 65 but in good health, and able to be examined, it is reasonable to do a pap test.

Breast Cancer--Mammography is recommended for women 50 years and older every 1 to 2 years. The current recommendation is to discuss  with the whether to obtain mammograms during between age 40 and age 50 as it is less clear if screening with mammography is beneficial is this age range. Discontinue offering screening after age 75. Order mammography by completing a Washington Radiology Associates form for "screening mammography", and asking the patient to make an appointment. This service is provider free to our patients.

Routine screening for prostate, ovarian, lung and other forms of cancer are not recommended by the Task Force.

Evaluating Outstanding Referrals

Tuesday, July 3, 2012

Evaluation of All outstanding Referrals

Lilian and I are going through all the outstanding referrals for whom appointments have not been obtained. You may see a message (JELLYBEAN to the right of T in the message section of the EMR) asking you to evaluate the need, and the urgency of a specific referral that has been made in the past --for a patient that you will be seeing at a scheduled visit. After you see the patient, you can TIME STAMP, and reply and send the message back to Lilian to answer the question about the patient after you have made the determination of need.

The T Jellybean is red if you have an urgent message. You have a message if there is a number inside the jellybean.  

So Please check all your messages before you see your patients the next time you are in the clinic.