National CRC Screening Summit | 2025-08 Open Access Colonoscopy

Video Transcription

Video Summary

Dr. Colleen Schmidt discussed open access (OA) colonoscopy as a solution to improve timely colorectal cancer screening by eliminating the prerequisite visit to a primary care physician before seeing a gastroenterologist. OA enables scheduling endoscopic procedures based on referrals without prior consultation, saving time and costs. Despite initial concerns about overuse and quality, OA now constitutes about 40% of colonoscopies in the U.S. and is supported by guidelines emphasizing pre-procedure assessment and informed consent, which may occur on the procedure day. Scheduling depends on insurance network status, patient health status (ASA classification), and procedure complexity. Challenges include ensuring appropriate indications, managing comorbidities, quality bowel prep, patient no-shows, and maintaining safety. Navigation programs significantly enhance outcomes by reducing cancellations and improving preparation quality. Examples from various institutions showed OA programs drastically cut wait times for colonoscopy. Key to success are clear protocols, communication among providers and schedulers, and coordinated patient follow-up, making OA a valuable tool to increase screening rates efficiently.

Keywords

open access colonoscopy

colorectal cancer screening

endoscopic procedure scheduling

patient navigation programs

procedure day informed consent

colonoscopy wait time reduction