Electronic health record tracking system may improve follow-ups after abnormal Pap results


An improved electronic health record tracking and reminder system improves patient follow-up after abnormal Pap results and increases compliance with ASCCP guidelines, according to a poster presentation at the Nurse Practitioners in Women’s Health (NPWH) 25th Annual Conference in Houston, Texas from September 28 to October 2022.

Almost half of all cervical cancer diagnoses are the result of a lack of follow-up after abnormal Pap results, and while the American Society for Colposcopy and Cervical Pathology (ASCCP) routinely develops risk-based algorithms for abnormal Pap result management and treatment, many practices are not in compliance because of the algorithms’ increasing levels of complexity.

To reduce practice- and provider-related barriers to abnormal Pap follow-up, and to increase compliance with ASCCP guidelines, researchers developed a quality improvement plan.1

The plan included an improved electronic health record (EHR) tracking and reminder system, which was developed and implemented at a large midwifery and women’s health practice in Utah. They issued post-intervention surveys to practitioners to measure acceptability and appropriateness, and to gauge how feasible it would be to implement the tracking and reminder system in other practices. To evaluate provider experience and satisfaction with the tracking system and gauge its success in reducing barriers to follow-up, researchers conducted post-intervention interviews.

Ultimately, they found that all surveyed providers (n=18) reported that the improved Pap tracking system reduced difficulty in managing abnormal Pap follow-up and helped to ensure that patients received appropriate follow-up care. Almost all providers (n=17) said the system helped reduce errors and cut down on time spent managing abnormal results. All providers (n=18) approved of the tracking system and saw it fit for improving ASCCP guideline compliance. Results also indicated a unanimous approval for implementing the system at other practices.

Although the research period has concluded, these providers continue to use the improved EHR tracking and reminder system because of the positive results it provided. Next steps, the authors wrote, include initiating EHR tracking functionalities within other practices that offer cervical cancer screenings.


Fuqua D, Taylor-Swanson L, Cole E. Cervical Cancer Prevention: Improving Abnormal Pap Follow-Up. Poster presentation at the 2022 Nurse Practitioners in Women’s Health 25th Annual Conference. September 28-October 2, 2022. Houston, Texas.

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