June 7, 2023

Viral video was viewed 16 million times and bolstered screenings by 36%.

STAR POWER Actors Ryan Reynolds and Rob McElhenney put their influence to good use in order to raise public awareness of the vital importance of colonoscopies.

When Ryan Reynolds, star of the popular Deadpool movies and perennial rom-com leading man, agreed to have his first colonoscopy filmed for public release, it wasn’t a zany social media stunt. It was to send a sincere message about the importance of these screenings.

At 46 years old, Mr. Reynolds is in the age group now recommended to get initial colorectal screenings. After losing a bet with friend and fellow Wrexham AFC co-owner Rob McElhenney of It’s Always Sunny in Philadelphia fame, Mr. Reynolds agreed to a “public” colonoscopy, and Mr. McElhenney, 45, magnanimously agreed to join him to raise awareness about the lifesaving capabilities of regular screenings. The actors’ procedures were effective. Mr. Reynolds’ doctor found and removed a potentially precancerous polyp, while Mr. McElhenney had three polyps removed.

Mr. Reynolds’ creative agency Maximum Effort teamed with the Colorectal Cancer Alliance’s LEAD FROM BEHIND initiative to create a sleek, humorous and well-produced video featuring interviews with the celebrities along with footage of their colonoscopies. The video was viewed 16 million times, but more impressive were its follow-on effects. The Colorectal Cancer Alliance reported that online booking platform Zocdoc reported a 36% increase in daily colonoscopy bookings after the launch, social media posts talking about #colonoscopy increased by 244%, and Google searches for “colonoscopy” and “colon cancer” rose by 129% and 113%, respectively.

Your ASC may not have the pull and resources of Hollywood stars and the Colorectal Cancer Alliance when it comes to marketing colonoscopies to prospective patients, but this project’s effectiveness reinforces how a little creativity can go a long way. Case in point: Robert Fusco, MD, gastroenterologist and regular colonoscopy patient, who sends hilarious holiday greeting cards to around 25,000 potential patients each year to encourage them to get their screenings. He says his efforts garner attention — and a lot of visits.

Its replacement, however, could prove just as controversial.

LIVES IN THE BALANCE GI physicians and associations warn that UnitedHealthcare’s new requirements could limit patient access to colonoscopies.

The American Gastroenterological Association (AGA) has announced that UnitedHealthcare (UHC), the country’s largest commercial health insurer, has backed down from implementing its controversial prior authorization policy. The aborted policy, which was slated to launch on June 1 and drew heated protest from AGA and many other parties in the larger GI community, would have required prior authorizations for colonoscopies and other endoscopic procedures.

However, gastroenterologists and GI centers are not out of the woods, as UHC replaced its planned prior authorization policy with something AGA describes as “nebulous”: the Gastroenterology Endoscopy Advance Notification program. According to reporting from Axios, this program requires clinicians to collect and submit patient data to UHC before performing a procedure.

“This program requires you to provide even more data on top of the current burdensome paperwork requirements,” writes AGA on its website. “It is a temporary patch. Patients will not be denied care immediately, but the downstream effects of the program could be as bad or worse for patient access. This misguided program involves a poorly defined and complicated administrative process that will ultimately impact millions of Americans who require colonoscopies or endoscopies and exacerbate administrative burdens.”

Adds AGA President Barbara H. Jung, MD, AGAF, “UHC’s slap-dash approach to rolling out a policy that will ultimately control patient access to critical, often lifesaving, medical procedures flies in the face of common sense and responsible medical practice. It also indicates that UHC does not currently have data that shows any significant overutilization of critical endoscopy and colonoscopy procedures that would ostensibly justify this program or prior authorization.”

According to Axios, UHC claims its desire for more information up front is to prevent procedures such as colonoscopies being performed unnecessarily according to clinical guidelines. AGA, many physicians and other GI-focused associations respond that this problem does not actually exist, and that in fact too few of these potentially lifesaving procedures are being performed. The publication also reports that providers who wish to qualify for UHC’s upcoming gold card program, which will allow physicians to bypass the prior authorization process after six months if they have a high percentage of approvals, are required to participate in the Advance Notification program.

“AGA is in this battle for the long haul, and we’re prepared to continue fighting for you and your patients,” writes AGA to its members. “This is not the end of the road.”

Learn how your GI facility can navigate the current colonoscopy boom

Photo by Maestro
A nurse manually searches through a canister of GI waste, trying to find a lost polyp.

Colonoscopy and colorectal cancer screening procedures are on the rise in facilities across the country. With the U.S. Preventive Services Task Force lowering the recommended initial screening age from 50 to 45, and patients rescheduling colonoscopies they postponed at the height of the pandemic, healthcare professionals in the GI space are busy.¹

There are five procedure rooms where Connie Hall, RN, a certified gastroenterology nurse, works.² Lately, 500 to 600 colonoscopies per month are performed with at least 1,000 patients waiting to be scheduled. “We’re on a trajectory to break any record we would have thought about setting,” says Hall.

What’s made a difference for Hall in efficiency and staff safety was switching from using canisters to a constantly closed waste management system. Previously, canisters had to be changed during a procedure – occasionally two to three times – and a lost polyp** meant manually searching through the GI waste.

“It was labor intensive to change out those canisters. The way you had to go through them to find a missing polyp, now that’s a day you don’t want to repeat very often,” Hall recalls. When Hall was on the design team at her new facility, purchasing Stryker’s Neptune Waste Management System was non-negotiable.

The Neptune System helps protect staff from biohazardous fluid exposure and streamlines the colonoscopy process because it reduces the need to empty canisters during a procedure. Hall said a recent nationwide shortage of canister liners was also a challenge for some facilities. Having a constantly closed waste management system can help combat that issue because GI waste is disposed through a hands-free docking station.

While upgrading a waste management system is a monetary investment, it's also an investment in safety for everyone in the room. Hall encourages pulling the safety card and getting infection control and employee health team members on board.

“It’s only going to take one splash in the face or contamination of a staff member to put everyone through the cleanup of biohazards, potential blood work and treatment for those affected,” Hall concludes. “Safety is a bigger commitment than it’s ever been in healthcare.”

Is your facility equipped to address the current colonoscopy boom? Stryker’s Neptune S Waste Management System was specifically designed for the GI space. Join us on our Journey to Zero* splashes and spills at safeor.com

Notes:
*Zero splash and spills, zero airborne contaminants, zero smoke, zero retained surgical sponges, zero blind spots, zero trips and falls, zero drug diversion, zero maternal harm, zero lost polyps, zero exposure, and zero doubt messages are not guarantees and are aspirational in nature.

**Polyps 2 mm or larger.

References:
1. Shaukat A, Church T. Colorectal cancer screening in the USA in the wake of COVID-19. Lancet Gastroenterol Hepatol. 2020 Aug;5(8):726-727. doi: 10.1016/S2468-1253(20)30191-6. Epub 2020 Jun 19. PMID: 32569576; PMCID: PMC7304951.

2. This is a paid interview with a Stryker nurse consultant, conducted March 22, 2023, on behalf of Stryker.