Impact of an Electronic Health Record Maintenance Alert on PSA Screening Rates in a 10-Hospital Integrated Health System

The Washington University

Status: Enrolling

Conditions: Prostate Cancer; Cancer of the Prostate

Treatments: Other: Annual PSA Health Maintenance Reminder

Study type: Interventional

Funder types: Other

Identifiers

NCT07109427

202507064

Details and patient eligibility

About

• The investigators propose a clinical trial to evaluate the impact of annual shared decision making for PSA screening, supported by system-level enhancements to promote evidence-based care:

• Defined referral thresholds within the health maintenance reminder, aligned with clinical risk stratification per NCCN guidelines.
• Enhanced clinical decision support (CDS) tools to reduce provider variation and ensure guideline-concordant screening and referral practices.
• The goal is to reduce late-stage presentation without increasing overdiagnosis-ensuring that prostate cancer screening is both accessible and clinically effective.

Enrollment: 40,000 estimated patients

Sex: Male

Ages: 40 to 75 years old

Volunteers: Accepts Healthy Volunteers

Inclusion and exclusion criteria

Eligibility Criteria:

• Receive care within the BJC Health System

• Have had at least one primary care physician appointment in the calendar year of PSA screening (primary care)

• Be male

• Not have a history of prostate cancer

• Meet one of the following risk criteria:

  • High Risk for Prostate Cancer

    • African American, between the ages of 40 and 75 (inclusive), or
    • Family history of prostate, breast, ovarian, and/or pancreatic cancer, or
    • Known familial germline mutation OR

  • Average Risk for Prostate Cancer

    • Between the ages of 50 and 75 (inclusive)

Trial design

Primary purpose: Health Services Research

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

---

40,000 participants in 1 patient group

Annual PSA Health Maintenance Reminder

Experimental group

Description:

An annual health maintenance reminder will be implemented for all men who meet the American Cancer Society guidelines for average- and high-risk eligibility criteria. The goal is to encourage their primary care provider (PCP) to engage in a shared decision-making discussion with the patient about the benefits and risks of prostate cancer screening. This alert will appear in the health maintenance reminder section of the electronic health record (EHR). Although all providers with access to EPIC can view the alert, it is typically the PCPs who review and take action on alerts in the health maintenance reminder section.

Treatment:

Other: Annual PSA Health Maintenance Reminder