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. 2022 Mar-Apr;20(2):123–129. doi: 10.1370/afm.2772

Table 1.

Overview of FQHC Program Components for CRC Screening

Program Component Standardized Workflows Flexible Workflows
Centralized mailed FIT Annually, the quality department is responsible for (1) identifying age-eligible members due for CRC screening, (2) partnering with a vendor to mail FITs and an information sheet in English and Spanish to each member’s address of record, and (3) generating a list of patients 4 weeks after the mailing who have not returned the mailed FIT. The quality department distributes these lists to each clinic; clinics are encouraged but not required to conduct patient outreach calls to encourage FIT completion.
Clinic-level workflows Daily, staff at individual clinics are expected to promote visit-based CRC screening emphasizing FIT by (1) chart scrubbing 1-2 days before scheduled appointments to identify patients due, (2) communicating to care team verbally (eg, huddle) or via notations on the schedule regarding who is coming in and due for CRC screening, and (3) reviewing the EHR point-of-care reminder system during patient rooming.
Medical assistants place a standing medical order for patients due and educate patients on CRC screening importance and how to complete the FIT. If patients decline FIT or prefer colonoscopy, medical assistants inform the provider, who will then engage the patient in a CRC screening discussion.
Other decisions regarding the type and frequency of CRC screening outreach, follow-up (eg, number and timing of patient reminders, patient incentives for FIT completion), and other strategies (eg, promotional flyers, health fairs) to encourage completion of FIT testing are determined by local clinic leadership and staff.

CRC = colorectal cancer; EHR = electronic health record; FIT = fecal immunochemical test; FQHC = federally qualified health center.