Preventive Screening is Gleaning for Good Health

ClinicalGuidelines-300x200Kaiser Permanente promotes wellness, delivers high quality care, and manages chronic disease in order to improve total health. Screening for health conditions is fundamental to this goal. This month, the Institute for Health Policy highlights Kaiser Permanente’s efforts to increase access to and quality of screenings as a way to better manage the health of our members.

Alcohol as a Vital Sign

The Kaiser Permanente Northern California Division of Research measured the results of Alcohol as a Vital Sign, a screening program in which medical assistants ask patients about their drinking behavior. The purpose of this program is to identify unhealthy levels of alcohol consumption and risk of alcohol dependency. Patient responses inform physician conversations — if patients report having unhealthy drinking levels, physicians can discuss the risks of overconsumption and the benefits of reducing consumption. Kaiser Permanente rolled out Alcohol as a Vital Sign across Northern California in 2013. Thus far, the program has shown positive results: 85 percent of the Northern California region’s patients have been screened for alcohol consumption, equal to the screening levels for smoking and exercise.

Higher Quality Colonoscopies, Lower Risk of Death from Colorectal Cancer

A recent study by Douglas A. Corley, MD, PhD, MPH, from the Kaiser Permanente Northern California Division of Research and Reinier G. S. Meester, MsC, from Erasmus University showed that improving colonoscopy adenoma detection rates (ADRs) may have long-term health benefits. Compared to unscreened patients, patients screened with low ADR colonoscopies had a 22 percent reduction in lifetime colorectal cancer incidence and a 57 percent reduction in colorectal cancer mortality. As ADRs increased, patients’ risks decreased further, the authors found. Patients screened with the highest ADR colonoscopies had much larger total reductions of incidence and death, compared to no screening, of 63 percent and 83 percent, respectively – additional relative reductions of 53 percent and 60 percent beyond those achieved with the lowest ADR tests. Although higher ADR colonoscopies are more expensive, researchers project these costs are almost completely offset by reductions in cancer treatment costs.

Expanded Blood Pressure Screenings for Hypertension Detection

Joel Handler, MD, and researchers from Kaiser Permanente Southern California’s Department of Research & Evaluation, were recently covered for their publication in The Journal of Clinical Hypertension. The team studied the benefits of screening for high blood pressure in non-primary care settings. To do so, they analyzed health records of Kaiser Permanente Southern California patients with hypertension to see if the condition was diagnosed during a primary care or specialty care visit. The study yielded two main findings. First, of hypertensive patients, 17 percent were diagnosed in specialty settings. Second, both primary care and non-primary care settings had comparable percentages of false positives, i.e. patients diagnosed with hypertension who did not have high blood pressure during follow-up. These results suggest that extending blood pressure screenings to non-primary care settings may be an effective way to detect hypertension, particularly for patients who do not regularly use primary care.

Kaiser Permanente is taking strides to improve members’ health by advancing quality of and access to screenings. These measures may help providers deliver more informed care and patients better manage their health. Next month’s research roundup will feature studies on the relationship between research and policy. For more information on this month’s research, Please contact Al Martinez at Albert.Martinez@kp.org.

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