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Health IT Success Stories

Dr. Aviado's Patients List Help Save a Life

'It helps you monitor your practice in ways not possible in the past' - Dr. Domingo G. Aviado, Milford, DE

"Thanks to early detection by the diligence of Dr. Aviado's staff and their EHR system, a patient's life was saved!"

Two of Dr. Aviado’s patients will be diagnosed with colorectal cancer (CRC) this year and for him this was one too many.

With the help of patient lists in an Electronic Health Records (EHR) system and a hard-working staff, Dr. Aviado was able to identify which of his patients were in need of CRC screenings and in result a patient’s life was saved.

“It (EHRs) not only helps efficiency in the practice, but it is well accepted by patients, it helps reduce errors, and most importantly, it helps you monitor your practice in ways not possible in the past” said Dr. Aviado.

Dr. Domingo G. Aviado, a solo-practitioner in Milford, DE, has been using EHRs in his practice since 2001. He has been working closely with Quality Insights of Delaware – Regional Extension Center (QIDE REC) to achieve meaningful use, and also better utilize his system to improve efficiencies and quality of care. Thanks to hard work and dedication, Dr. Aviado successfully attested to Meaningful Use Stage 1 and is awaiting his EHR incentive payment from CMS.

How Quality Insights of Delaware – Regional Extension Center (QIDE REC) Supported Dr. Aviado

  • Assisted with EHR update to a certified EHR version
  • Refined workflow to capture CRC screenings
  • Assisted with CRC measures, improvements rates, and postcards for patient reminders
  • Defined quality reporting measures to monitor CRC screenings
  • Built customized CRC reports in EHR to collect data
  • Provided analysis of monthly CRC data
  • Provided monthly data feedback reports to identify barriers and mitigate solutions
  • Identified best practices with this EHR vendor's application

EHR Patient Lists Used to Track Colorectal Cancer (CRC) Screenings

Dr. Aviado has approximately 4,000 active patients, and based on the incidence of colorectal cancer (CRC) in the country, he expects to see at least two cases of CRC in his practice per year. Based on this alarming statistic, Dr. Aviado enlisted the help of Quality Insights to develop a reporting module in his EHR to monitor and ultimately increase the number of his patients who receive CRC screenings.

"Within the last twelve months, our rate of colorectal cancer screenings has gone from 40% to 52% for patients in the 50 and over age range who need to have the testing done" said Dr. Aviado.

Dr. Aviado's EHR system identified 200 patients from his patient list who were age 50 and older and who needed a CRC screening. A mailing was sent out to all 200 patients, resulting in a response from 122 patients. It was discovered that 49 of those people already had a CRC screening done (and the EHR needed to be updated), and 73 were due for a screening. Of those 73, 65 people agreed to have the CRC screening.

Patient Outcomes

There was one patient, who was identified as needing a screening from the EHR patient list, who elected to have the CRC screening done and was found to have early stages of CRC. This patient is now in treatment and is expected to make a full recovery. Thanks to early detection brought about by the diligence of Dr. Aviado's staff and their EHR system, this patient's life was saved!


Dr. Aviado and his staff faced a few barriers while implementing their patient list. They found that the CRC initiative required considerably more staff time than originally anticipated. Staff time was invested to send out the CRC notifications and to conduct phone follow-ups in order to generate patient responses. The staff’s knowledge of their EHR system to generate reports was initially a hurdle, but as a result, their system knowledge has now been expanded thanks to this initiative.

Lessons Learned

After implementing the EHR system the staff realized that the practice data was easier to analyze than they first thought. It was also learned that patients want to be reminded of steps they need to take to help prevent illness. The most important lesson learned was the realization that proactively notifying patients of overdue tests can save a life.

View the video of Dr. Aviado discussing the CRC initiative that he participated in with QIDE REC.