Table 5.

Common Barriers and Supports for Increasing Cancer Screening Expressed During Focus Groups and Key Informant Interviews at 23 Primary Care Practices Enrolled in the Practice Facilitation and Academic Detailing Project, 2014–2015

Barriers to Increased ScreeningSupports of Increased Screening
Patient level∙ Transportation∙ Education and outreach
∙ Insurance/financial constraints∙ Case management and follow up
∙ Language/communication issues at the point of care∙ Lifestyle-amenable screening methods
∙ Comprehension∙ Reduction of structural barriers
∙ Refusal/noncompliance
Staff level∙ Lack of time∙ Shared responsibility to discuss and document screening with patients
∙ EHR data errors∙ Standardized data entry and/or EHR technical assistance
∙ Lack of investment in quality improvement interventions∙ Performance assessment and feedback
∙ Point-of-care reminders
Practice level∙ Lack of personnel∙ Quality improvement coaching
∙ Workflow inefficiencies∙ Workflow assessment and adjustment
∙ EHR data errors and reporting limitations∙ EHR “workarounds”
∙ Two-way communication with specialists∙ PCMH certification requirements
∙ EHR technical assistance
  • EHR, electronic health record; PCMH, patient-centered medical home.