A recent study published in the journal Gastroenterology links longer colonoscopy screening time with reduced risk for cancer. The study's results support withdrawal time as a colonoscopy quality indicator. William Katkov, MD, a gastroenterologist at Providence Saint John's Health Center in Santa Monica, Calif., explains what this study means for practicing gastroenterologists.
Question: Why is this study important for the GI field?
Dr. William Katkov: This is an important and well-designed study that supports existing recommendations. Scope withdrawal time as a quality metric is firmly established in gastroenterology practice. It has been linked to reimbursement and bonuses by CMS as well as the insurance industry. Quality improvement, in colonoscopy, has the goal of reducing complications including the occurrence of interval cancers between screening exams. Several factors enhance quality including prep quality, state-of-the-art equipment and withdrawal time highlighted in the current study.
Q: How can gastroenterologists balance hitting withdrawal time benchmarks with efficiency?
WK: The evidence, as presented in this study, supporting colonoscope withdrawal times greater than six minutes, is so strong and compelling that any definition of efficiency must take this into account. The costs of poorly performed colonoscopies are unacceptable, and the optimal care of our patients must always remain our highest priority.
Q: How do quality benchmarks and the increasing need for quality reporting affecting gastroenterologists?
WK: The evidence-based implementation of quality metrics can serve to improve the practice of gastroenterology. However, the requirement to report these measures can be cumbersome and expensive. Many gastroenterologists, and endoscopy centers, will incur the cost of acquiring technology that will make quality benchmark recording and reporting automatic.