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SATIS-PHI/CRC Master Patient Database Elements

Below is a list of key elements that we suggest you use to implement and track the SATIS-PHI/CRC intervention. These elements can be incorporated into a separate database, or they can be obtained from your existing electronic record infrastructure. Items marked with a ^b are optional, but we suggest that you try to record and track them.

If you plan to conduct an assessment of the SATIS-PHI/CRC intervention, we strongly recommend collecting all of these data elements as well as others that may be unique to your setting. You may also find it helpful to track the dates of many of these data elements (e.g., mailing dates, request dates, and notification dates). This will help you establish an "analytical database" that can be useful for assessment purposes.

Patient Elements

• Patient name
• Patient identification code^a
• Patient mailing address
• Date of birth of patient and/or age of patient
• Practice name
• Reason for ineligibility (i.e., evidence of prior diagnosis of CRC or polyps or inflammatory bowel disease, evidence of family history of CRC diagnosis before age 60, evidence of recent prior CRC screening test, not a patient of the practice)
• Sex^b
• Race^b
• Ethnicity^b
• Marital status^b
• Insurance status^b
• Mailed invitation to screen^b
• Mailed reminders^b
• Requested stool test kit^b
• Sent stool test kit to requesting patient^b
• Stool test completed
• Patient notified of stool test result
• Stool test result
• Complete diagnostic exam (CDE) recommended (i.e., followup colonoscopy recommended)
• CDE completed
• CDE patient notified
• CDE result
• Colonoscopy scheduled
• Colonoscopy completed
• Patient notified of colonoscopy result
• Colonoscopy result
• Other screening completed (e.g., flexible sigmoidoscopy or barium enema)
• Other screening patient notified
• Other screening result

SEA Form Elements^b

• Mailed SEA^b
• Responded to SEA^b
• Reason for ineligibility (Section A response)^b
• Ethnicity (Section B1 response)^b
• Race (Section B2 response)^b
• Marital status (Section B3 response)^b
• Language preference (Section B4 response)^b
• Education (Section B5 response)^b
• Health status (Section B6 response)^b
• Opt-out (Section C response)^b

Practice Elements

• Practice name
• Practice identification code^a
• Practice affiliation^b
• Practice geographic location (e.g., urban, rural)^b
• Presence of electronic medical record in the practice^b
• Practice size (e.g., large, small)^b
• Practice specialty (e.g., general internal medicine, family medicine)^b

^a Identification numbers can be useful for addressing HIPAA and other privacy and confidentiality concerns.
^b Optional data elements.

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