Using REDCap to Address Gaps in Electronic Health Record Data for Strengthening Colorectal Cancer Screening and Navigation.

BACKGROUND

Despite widespread adoption of electronic health records (EHRs), colorectal cancer (CRC) screening rates remain suboptimal, particularly in underserved regions. This study aimed to evaluate the impact of a secure, HIPAA-compliant REDCap system on patient navigation and CRC screening outcomes within the West Virginia Program to Increase Colorectal Cancer Screening (WVPICCS) initiative.

METHODS

A REDCap database was developed to complement existing EHRs, capturing patient demographics, CRC screening history, and navigation activities. Structured forms documented referrals, results, and follow-up actions for various screening modalities. Custom EHR reports and Microsoft Access queries combined REDCap and EHR data, enabling teams to identify at-risk patients, address barriers (eg, insurance, transportation), and prioritize care. Descriptive statistics and contingency analyses were performed to assess screening completion rates and the association of navigation with screening uptake.

RESULTS

Among 4,654 identified patients, 2,222 (47.7%) were screened for colorectal cancer. A subset of 893 patients was tracked for navigation outcomes; 109 (12.2%) received navigation. Navigation uptake varied by site, ranging from 9.2% to 17.7%. Patients receiving navigation were more likely to complete CRC screening (39.5% vs. 31.0%), although this difference did not meet conventional significance in two-tailed tests (p > 0.05). Subgroup analyses indicated that even among patients with documented barriers (n = 42), navigated individuals achieved higher screening rates (38.1%) than those without navigation (31.0%), suggesting potential clinical benefit.

CONCLUSIONS

Implementing a REDCap-based patient navigation system helped identify, track, and support at-risk patients, contributing to modest yet meaningful improvements in CRC screening rates. Refining and expanding these data systems is important in overcoming persistent challenges in CRC early detection, supporting better health outcomes and reduced CRC burden.