WV PICCS TODAY. Note of Appreciation. A newsletter for our partners. In This Issue. December 2016

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Hannah Russell
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Of course, I readily agreed, let the idea roll around for a few days wondering how to convey to clinic partners and staff the deep gratitude and admiration I feel for the accomplishments and

1 WV PICCS TODAY A newsletter for our partners December 2016 Note of Appreciation Earlier this month the WV PICCS staff asked me to contribute to the upcoming newsletter by writing a brief article on my view of the Program as the PI (Principal Investigator). Of course, I readily agreed, let the idea roll around for a few days wondering how to convey to clinic partners and staff the deep gratitude and admiration I feel for the accomplishments and commitments demonstrated over the last 18 months, and then busied myself with other tasks. Tonight, with a deadline looming I still face the same dilemma. It is rare in the work we do to experience success so quickly, to see the fruits of our labors realized in data that reflects implementation of protocols and change in actual screening numbers. Through collaboration in 18 months we launched a brand-new program, brought on 24 clinic partners, trained more than 460 clinic staff, and moved colorectal cancer screening rates in the first 16 clinics from 28% at baseline to 48% nine months into implementation. With the expansion of new clinics and an upcoming outreach project with one of the major insurance companies in our state (more to come on that in the near future), we are uniquely positioned to address one of West Virginia s most preventable cancer burdens: colorectal cancer. Amit Ray in his bestselling book, Walking the Path of Compassion states, Some fish love to swim upstream. Some people love to overcome challenges. When I reflect on the WV PICCS team, made up of staff and clinic partners from around our state, I think that this quote sums it up best: as a leader, I am fortunate and thankful to be surrounded by people who love to overcome challenges and together we will work to benefit the people of our state. With Thanks, Stephenie K. Kennedy, Ed.D. Stephenie K. Kennedy, Ed.D. Director, Cancer Prevention and Control Associate Center Director, WVU Cancer Institute Research Assistant Professor, School of Medicine West Virginia University In This Issue Note of Appreciation Year 2 Awardees Sustainability Plans All-Star Partner Late-Stage CRC Diagnosis CT Colonography & FIT DNA Event Announcement Strollin Colon

2 Welcome Year 2 Awardees! WV PICCS is pleased to announce eight new partner clinics in Year 2 of its 5 year grant with the Centers for Disease Control and Prevention. These new clinics join the 16 clinics that were previously awarded in Year 1 of the program. Year 2 clinics are currently participating in onboarding activities such as initial staff and provider training, health information technology assessments, and planning meetings. Implementation activities will begin in January. Year 2 awardees have widened the reach of WV PICCS across West Virginia. Eighteen of West Virginia s 55 counties now have a clinic participating in the initiative. I think it is important to note that these are just the counties where the awardee clinics are located. It does not count the reach into adjacent counties that these clinics have in their region, said Mary Ellen Conn, Director of WV PICCS. Many of the partner clinics in Year 2 are in areas with high levels of late-stage diagnosis of colorectal cancer. We know that WV PICCS can have a real impact in these areas. If we can increase screening in these counties, we can find cancer earlier and patients have better health outcomes, said Stephenie Kennedy, Associate Director of Cancer Prevention and Control at the WVU Cancer Institute. Colorectal cancer is a significant problem in the Mountain State. It is the 2 nd leading cause of cancer-related death in West Virginia. By partnering with primary care clinics throughout the state, we can put proven strategies in place that can increase the number of individuals who get screened for this disease. The earlier colon cancer is found, the easier it is to treat and cure, said Ms. Conn. WV PICCS is directed through Cancer Prevention and Control at the WVU Cancer Institute.

Year 1 Clinics: Planning for Sustainability WV PICCS staff extends a warm thank you to all of our partner clinics participating in Year 1 of our program.

January marks the beginning of the sustainability phase of the project with our Year 1 clinics.

3 Year 1 Clinics: Planning for Sustainability WV PICCS staff extends a warm thank you to all of our partner clinics participating in Year 1 of our program. We enjoyed our time working together during the implementation phase and are excited to continue our partnership going forward. January marks the beginning of the sustainability phase of the project with our Year 1 clinics. By the end of December, all Year 1 clinics will complete a sustainability plan with their WV PICCS contact. This plan serves as a working document to guide activities during the sustainability phase of the project. During the sustainability phase, Year 1 clinics will no longer have monthly site visits but WV PICCS will maintain regular contact with each Year 1 site to assess progress and troubleshoot any issues as they arise. In addition, your WV PICCS contact will make an additional 2-3 site visits prior to the project completion at the end of June. Please continue to see us as a resource if you have any questions or concerns going forward. We value the progress we have made together so far and are thrilled to continue our partnership now and in the future. All-Star Partner Spotlight: Tracie Hosey WV PICCS Today will feature an All-Star Partner Spotlight in each newsletter. All-Stars demonstrate a commitment to improving CRC screening rates in their clinics through hard work, dedication, and perseverance. All-Stars are selected quarterly (next issue published in March 2017). If you would like to nominate an All-Star, please Dannell Boatman at dboatman@hsc.wvu.edu or talk with your WV PICCS contact. Tracie Hosey, Care Manager at Minnie Hamilton Health System (MHHS), has demonstrated her dedication to the CRC screening project by performing her role diligently and effectively. Tracie completes call reminders to all patients who have received FIT kits at either the Grantsville and Glenville MHHS clinic locations. After six months of implementation, FIT kit return rates at Grantsville have increased by 17% and Glenville have increased by 9%. In addition, Tracie started an outreach program where she cold-calls patients with no recent appointment who are due for CRC screening. Using her superior communication skills, she is able to personalize the CRC risk to patients during her calls. If the patient agrees, Tracie sends them a free FIT kit in the mail. This effort has paid off for MHHS. The current return rate for this outreach effort is 64%. Since this initiative began in March, the return rate has grown by 37%. Tracie is a joy to work with! She is always willing to put in the work to get the job done. She is bright, cheerful and always has a smile on her face, said Dannell Boatman, MHHS WV PICCS contact. Tracie is a fantastic advocate for her patients. Her successful cold-call project is inspiring. These folks would not have been screened without her efforts! Kudos to Tracie for her hard work and dedication MHHS CRC screening project!

4 Did You Know? Late-Stage Colorectal Cancer Diagnosis Is Related to Relative Survival Rates. Age-Adjusted Late Stage CRC Incidence Rates by County Ages 50+, WV, Source: West Virginia Cancer Registry Age 50+ Late-stage CRC Rate < to 86.1 > 86.1 West Virginia has a high rate of late-stage diagnosis of colorectal cancer. The state average rate of late-stage colorectal cancer diagnosis is Many counties have rates that far exceed this average (see map above). It is in these counties that we know colorectal cancer screening can have an increased impact on colorectal cancer mortality rates. Regular screening for colorectal cancer saves lives. The earlier cancer is found, the more easily it can be treated and patients have better health outcomes. According to the American Cancer Society, if colorectal cancer is found early, at a localized stage, patients have a 90% 5-year relative survival rate. In contrast, if the cancer has spread and is at a distant stage, 5-year relative survival rate drops to 13%. By increasing and promoting access to screening we can change this trend and improve outcomes.

A Closer Look: CT Colonography & FIT DNA The United States Preventive Services Task Force updated their colorectal cancer screening recommendations in June 2016.

While these new options offer greater choice to patients, please keep in mind that not all insurances cover these tests at this time.

5 A Closer Look: CT Colonography & FIT DNA The United States Preventive Services Task Force updated their colorectal cancer screening recommendations in June The new guidelines add two new testing options for patients: CT Colonographym and FIT DNA. While these new options offer greater choice to patients, please keep in mind that not all insurances cover these tests at this time. In addition, they have not been added to UDS measures at this point. We anticipate these changes will be made in the near future. CT COLONOGRAPHY CT Colonography, commonly referred to as Virtual Colonoscopy, uses a small tube which is inserted a short distance in the rectum and allows for inflation of the bowels with air. Low dose CT radiation is used to scan and take images of the colon. It is a less invasive way to view the entire colon. This test, if negative, would need to be completed every 5 years. A follow-up colonoscopy would need to be conducted for any positive findings. Like the colonoscopy, this test is done in the hospital and requires bowel preparation. FIT DNA The lining of your colon sheds cells every day. If precancer or cancer is present, these cells will shed as well. When you have a bowel movement, these shedding cells are picked up as the stool passes through your colon. FIT DNA technology can detect the presence of abnormal DNA and hemoglobin released from precancer or cancer cells. FIT DNA is a highly-sensitive test that can be completed every year or 3 years depending on the brand selected. There are no medicine or dietary restrictions. FIT DNA is not as specific to human blood as FIT so this may lead to more false negatives. It is more sensitive than FIT per a single screening test. Stool DNA has a 93.3% accuracy in detecting Stage I to IIII colorectal cancer. More information about the accuracy of this test can be obtained through an article published in The New England Journal of Medicine. FIT DNA was added to HEDIS measures on October 3, 2016.

EVENT ANNOUNCEMENT Colorectal Cancer Summits Bridgeport, WV Beckley, WV March 2017 August/September 2017 Additional information

Strollin Across WV WV PICCS is pleased to offer the Strollin Colon as a resource for our partner clinics.

The structure shows what a healthy colon looks like as well as what it looks like when cancer is present.

6 EVENT ANNOUNCEMENT Colorectal Cancer Summits Bridgeport, WV Beckley, WV March 2017 August/September 2017 Additional information about these events will be shared with our partner clinics in the near future. Strollin Across WV WV PICCS is pleased to offer the Strollin Colon as a resource for our partner clinics. This exhibit is a10 foot by 12 foot inflatable colon. The structure shows what a healthy colon looks like as well as what it looks like when cancer is present. In 2016, the Strollin Colon was featured at nine events in nine different counties. Approximately 550 people were touched by this special exhibit. If you are interested in hosting the Strollin Colon in your community, reach out to your WV PICCS contact for additional information. From your WV PICCS partners

Blue Star Sunday. Increasing Awareness About Colon Cancer. Dear Faith Community,

Blue Star Sunday. Increasing Awareness About Colon Cancer. Dear Faith Community, Blue Star Sunday Increasing Awareness About Colon Cancer Dear Faith Community, West Virginia s Cancer Coalition, Mountains of Hope, invites your faith community to participate in Colorectal Cancer Awareness