Colorectal cancer screening in the framework of the medical home model: findings from focus groups and interviews.

A recent report from a survey of 15 primary care practices revealed considerable variability and much room for improvement in aspects of primary care practice that are associated with increased colorectal cancer screening rates. There was low utilization of patient reminders, tracking of test completion, rescheduling of missed appointments, and inconsistent follow-up of positive stool blood tests. Qualitative data collected in the same study provide insights into how the practices operated. Focus group discussions with the clinicians and staff of the practices and key informant interviews with office managers support the survey findings by shedding light on a lack of office policies and systems. Many practices lacked a systematic way to identify patients who were not up to date on screening while they were visiting the practice, thereby passing up the best opportunity to reach them. These findings are not consistent with the patient-centered medical home model.