Project Happy Birthday: Improving Access to Colorectal Cancer Screenings




Alpers, Gwendolyn
Atamosa, Laura
Garcia, Gabriela

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This research project was completed as part of the 8th Annual Cleveland Clinic Case Competition. We were tasked by the health system’s executive leadership to develop a plan for resuming the Cleveland Clinic’s colonoscopy screening program post COVID-19 and expand access to the program to members of the surrounding community. Millions of adults aged 50 to 75 are not up to date on their screenings for colorectal cancer and now, because of the disruption caused by the COVID-19 pandemic, even fewer people are willing to receive necessary screenings. To generate possible solutions to this problem, our team conducted extensive research on the current healthcare environment and analyzed Cleveland Clinic’s financial data. From our research, we developed an integrated growth plan that includes a short-term and a long-term growth strategy that addresses how to move forward in the post COVID-19 healthcare environment. Our solution to revitalizing the Cleveland Clinic’s colonoscopy screening program is to implement our program: Project Happy Birthday. Our plan is to create a direct-mail, screening program that allows patients to receive colorectal testing from the comfort of their home and empower individuals to take charge of their health. Each year on their birthday, patients will receive a Fecal Immunochemical Test (FIT) kit and a personalized birthday card. We will use FIT kits as our primary screening tool because it is affordable, fairly accurate, and covered by nearly all insurance providers, including Medicare and Medicaid. We found that the average cost of implementing a direct-mail intervention program was $40.00 per kit returned. In comparison, the average allowed cost for an episode of colonoscopy in 2010 was $2,146 among the commercial population and $1,071 within the Medicare population. Even though FIT kits require yearly intervention, their use results in greater cost savings in the long run. If the initial program is successful, a fleet of mobile health units that serve populations in and around Northeast Ohio will dispense free FIT kits to disadvantaged and underserved populations. Mobile units will park in easily accessible places around the community, such as malls, large bus stations, grocery stores, and religious centers. A trio made up of two registered nurses and one licensed practical nurse will work with these mobile health units and give onsite educational talks on the benefits of screenings and the potential risks of dismissing cancer screenings. The program will be partially funded by the cost savings that result from Project Happy Birthday. Other types of tests and the delivery of more complicated care can be provided as the program grows. With proper testing and screening for colorectal cancer, patients will experience better health outcomes and Cleveland Clinic will better be able to promote the long-term health of the communities they serve.



healthcare, colorectal cancer, Cleveland Clinic, colonoscopy screenings


Alpers, G., Atamosa, L., & Garcia, G. (2021). Project happy birthday: Improving access to colorectal cancer screenings. Poster presented at the International Research Conference for Graduate Students, San Marcos, Texas.


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