What We Learned at Connected by Care for Colorectal Cancer

Colorectal Cancer is now a leading cause of cancer death, it doesn't have to stay that way if we lead with equity and innovation. Below is a summary of the high-impact strategies and "playbooks" shared by our panel of safety-net innovators to help you close the screening gap in your community.

The "Presumptive YES" & Leading with Connection

One of the most powerful themes of the day was shifting our mindset from asking permission to assuming action.

• At Norton Sound Health Corporation, Dr. Megan maintains a 75-77% screening rate by using a "Presumptive YES" approach. Instead of asking "if" a patient wants a colonoscopy, her team asks, "Do you want your colonoscopy this week or next month?".
• We learned the organizations at this panel have screening starting as early as age 40 to establish it as a standard of care.
• Lastly, engagement isn't just clinical; it’s human. Teams from these organizations send birthday cards and texts detailing exactly what a patient is due for, treating "non-biological" extended family with the same urgency as immediate relatives.

What are the secrets to improving rates?

Our panelists shared their "secret sauce" for moving the needle on quality benchmarks.

• Erin Howes from PrimeCare Health focuses on "friendly competition" and breaking complex 80% screening goals into smaller, manageable segments. Her "Sticky Note Playbook" is simple: if she has a good idea, it goes on the wall to be tested.
• Mikala Balk from Wesley Community Health Center made it a point to tackle the high cost and logistical hurdles of colonoscopies. Mikala is also currently experimenting with partnering with medical students to provide screenings!
• Dr. Rogers of Rogers Solutions Group highlighted the need for "creativity in communication," using everything from billboards and social media campaigns to personalize patient outreach.
• Elizabeth Leffler of Pokagon Band Of Potawatomi discussed how clinics can adapt their engagement strategies to support various experiments, such as mobile vans or new clinical partnerships.

Engagement is Not Outreach: 5 Equity-Centered Strategies

We moved beyond theory to identify the three pillars of barriers: Structural, Behavioral, and Engagement. To bridge these gaps, we must remember that "engagement" is an active partnership, not just checking a box. Dr. Rogers shared the following: 

• Normalize the Conversation: Move screening discussions outside of just annual visits to destigmatize the process.
• Use Trusted Messengers: Leverage staff and community members patients already know and trust.
• Default to Action: Track actual test completions, not just the "intent" to get screened.
• Close the Loop: Ensure there is a rigorous system for following up after abnormal FIT results or referrals.
• Identify Data that Matters: Focus on FIT kit return rates and the time to colonoscopy completion after an abnormal result.

Additional Community Resources:

• Spreading Awareness to a Younger Audience - CRC and Me
• Colorectal Cancer Alliance Helpline
• American Indian Cancer Foundation CRC Resources
• Recording of Achieving Success with Top Tier Screening Rates
• Recording of Overcoming Barriers to Colorectal Cancer Screening with Practical Tools
• Recording of Digital Connection and Reimagining Patient Outreach

Final Thought: Meeting Patients Where They Are

Success isn't theoretical. It is found in the "baby steps" at the front desk, the birthday text, and the mobile clinic van. When something doesn't work, let it go and try the next experiment. Together, everyone achieves more.