Prevention/Care Management, 2004

Mayo Clinic

June 2004

The Disease Management Strategies Department of Mayo Clinic in Rochester used the U.S. Preventive Services Task Force recommendations and resources and AHRQ's prevention implementation program (PPIP) to create a tool, called "Green Apple," to track patients' preventive care on a visit-by-visit basis. The Green Apple tool was the precursor to the development of the preventive services flow sheet that is within the electronic medical record.

Tied to the electronic medical record of each patient, Green Apple is a critical component of a team-based approach to ensure proper preventive care for each patient. Under this model, clinical assistants and receptionists distribute preventive care information; LPN's and RN's review, monitor, and update records of preventive care; and physicians use evidence-based algorithms to recommend and standardize care for all patients.

The following results were collected through an annual audit of Mayo Clinic's delivery of preventive services after implementing the Green Apple tool:

• Documentation for timely cholesterol screening improved from 85 to 91 percent.
• Cervical cancer screening increased from 88 to 90 percent.
• Tobacco use assessment increased from 95 to 97 percent.
• Breast cancer screening (mammography) increased from 75 to 84 percent.

Because Mayo Clinic in Rochester provided care to 319,687 patients in 2003, these percentage increases in the delivery of preventive care represent significant improvements.

Overcoming barriers that prevent clinicians from incorporating preventive services as a routine part of their patient care is a priority of the Disease Management Strategies Department. The Disease Management Strategies team, and its use of AHRQ preventive care research, highlights the importance of developing and refining systems that use a team-based approach and incorporate appropriate tools for the routine and efficient delivery of preventive care.

Impact Case Study Identifier: OCKT 04-08
AHRQ-Sponsored Activities: U.S. Preventive Services Task Force (USPSTF), Put Prevention Into Practice (PPIP)
Topic(s): Prevention
Scope: Minnesota

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