• Learn How to Improve Time-to-Diagnosis for Cancer

    AHRQ Safety Program for Telemedicine Aims to Improve Diagnostic Pathway

    March 28, 2023, News Staff — Cancer screening is an essential component of primary care and a service family physicians regularly provide, with abnormal screening results prompting appropriate follow-up to confirm or rule out a cancer diagnosis.

    Historically, this diagnostic process has played out in the context of in-person visits. But given the rapid growth of telemedicine during the COVID-19 pandemic and its continued use in many primary care settings, some portions of the process may now occur via telemedicine.

    It’s important to acknowledge that telemedicine can be both a barrier and a facilitator of the diagnostic process. Although telemedicine may limit the opportunity to do a physical examination, for example, it can boost access to care that patients may otherwise defer — as was seen during the pandemic — and enable closer patient follow-up.

    Research examining the pandemic’s impact on regular care delivery suggests that many patients deferred routine care such as cancer screenings, leading to delayed identification of new cancers and concerns about a potential rise in cancers diagnosed at a later stage. These findings offer a cautionary tale about the effects of delayed care and disruptions in cancer screening programs.

    To reduce diagnostic delays and miscues that can result in adverse outcomes, the Agency for Healthcare Research and Quality is recruiting ambulatory and primary care practices — only those with a physical location need apply — to participate in the AHRQ Safety Program for Telemedicine: Improving the Diagnostic Process. This free program, which focuses on helping practices improve the diagnosis of breast, lung and colorectal cancers, will launch this June and run through November 2024. 

    Participating practices will gain access to evidence-based safety practices, personalized coaching by physicians with subject matter expertise, and technical assistance and peer support through regular coaching calls.

    Additional program benefits include

    • greater teamwork and communication,
    • heightened emphasis on patient safety, and
    • eligibility for continuing education credits.

    According to AHRQ’s announcement, “The program will combine evidence-based guidance with implementation strategies to improve the cancer diagnostic process within a telemedicine setting by developing a culture of patient safety and improving communication and teamwork between health care professionals and staff and among clinicians and patients.”

    Specifically, the program will focus on closing care gaps, follow-up needs and referral loops in five error-prone steps in the cancer diagnostic pathway:

    1. follow-up of abnormal screening tests
    2. follow-up of incidental findings on imaging
    3. follow-up of abnormal test results
    4. follow-up of consults and referrals
    5. management of diagnostic uncertainty

    Adult and family primary care practices, gynecology practices, and community-based health clinics that diagnose or have abnormal screenings for 12 or more breast, lung or colorectal cancers per year are eligible to participate. In addition to having a brick-and-mortar location, practices must already be using telehealth and have video-based telemedicine capabilities. 

    Review an online FAQ document for further information about program specifics.

    This program focused on optimizing cancer diagnosis processes is one of two components of the AHRQ Safety Program for Telemedicine, a national initiative designed to improve telemedicine delivery in primary care settings. Recruitment for the second component, which will focus on antibiotic use, will begin in December. 

    Each component of the initiative is designed to provide evidence-based patient safety practices, individualized expert coaching and technical assistance from physician subject matter experts to support practices in

    • understanding the science of safety and how it applies to the cancer diagnostic process and/or antibiotic use,
    • improving teamwork and communication, and
    • designing and implementing interventions to improve the cancer diagnostic process and/or antibiotic use within a telemedicine setting.

    The overall initiative is funded and guided by AHRQ and implemented by NORC at the University of Chicago, the Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality, and Baylor College of Medicine.

    The deadline to apply to participate in the AHRQ Safety Program for Telemedicine: Improving the Diagnostic Process is May 25. Informational webinars will be offered on several dates, and online registration is open. A webinar transcript and slides also are available.