Convenient Self-Scheduling Options for Screening Mammograms Reduce Disparities and Improve Access for New and Existing Patients
In California, 19% of of all women report not having a personal doctor, but significant disparities exist by race and ethnicity. Twice as many Hispanic women report not having a personal doctor compared to White women (28% and 14% respectively).*
The UCSF Breast Care Center has been working to leverage digital health to reduce barriers for all patients to receive the care they need. As of April 25, 2022, patients with breast cancer symptoms or elevated risk of cancer due to genetic mutation or family history have been able to self-schedule their screening mammograms directly from the website with a Nurse Practitioner who can work up their symptoms or develop a personalized surveillance plan for them. Since then, 30 patients have taken advantage of this feature and 43% of these appointments have been made outside of the clinic’s hours of operation, demonstrating the need to allow patients to work outside the traditional bounds of the healthcare system.
In March of 2021, screening mammograms ordered within UCSF began automatically generating a MyChart scheduling ticket to allow patients to conveniently schedule their study through MyChart. In addition to allowing patients to schedule on their own time without back and forth with the clinic or having to endure extended hold times, empowering patients in this way reduces the amount of work for the scheduling team and allows them to focus on higher complexity coordination.
During the height of the pandemic, both screening mammography and breast cancer diagnosis decreased. Although we have seen significant rebounds, they are not back fully to their pre-pandemic levels. There is growing concern that this could lead to a rise in future cancer diagnoses and a larger proportion of later-stage diagnoses with associated worse prognoses. **
In honor of Breast Cancer Awareness month in October, we will be expanding our digital options by launching the ability for patients to self-schedule their screening mammograms without requiring a physician order. Beyond extending our digital reach, our physical mammography footprint has greatly expanded in recent years. Two years ago, UCSF mammography was available exclusively in the city of San Francisco. Now services are available to patients at five sites including Berkeley in the East Bay and San Mateo on the Peninsula. It is our hope that continuing to push ourselves to anticipate the barriers patients face and offering options to meet them where they are will drive a more efficient, accessible, and equitable system for our patients and healthcare workers.
Where is Web Self-Scheduling Available?
* Source: KFF analysis of the Centers for Disease Control and Prevention (CDC)'s 2020 Behavioral Risk Factor Surveillance System (BRFSS).
** Source: Journal of the American College of Radiology Volume 19, Issue 8 P919-934 August 1, 2022 Impact of the COVID-19 Pandemic on Breast Imaging: An analysis of the National Mammography Database.