More Than Just a Number
The pandemic impacted so many parts of so many people’s lives. While battling COVID-19, each of us have taken extra precautions to protect ourselves and others and have made unprecedented changes to each of our lives. In doing so, we knew our social lives would change, but perhaps didn’t immediately realize that the pandemic would have another very serious consequence. In March of 2020, uncertainty around COVID and its transmission caused many things to be stopped abruptly—including our best tool in the fight against breast cancer, mammography.
Early detection of breast cancer through mammography and other screening tools is critical to a successful battle against breast cancer. Diagnoses in early stages mean there are more options available to patients, more tools for doctors, and a better chance at beating cancer. Delays in mammograms means delays in cancer diagnosis and delays in treatment— each leads to the other and stacks up to potentially deadly consequences.
As information about the spread of COVID became available, Logan Health worked quickly to implement new standards of care, including increased cleaning and changed scheduling protocols that made mammography services readily accessible and available. Through a staged and careful plan, mammography services were ramped up starting in May 2020 and were back at full capacity in October 2020. However, even as access improved, women were slow to return to receive their annual mammogram.
Early into 2021, the breast imaging team realized that women in our community were not returning as expected. Because many women had not received their screening mammograms in spring of 2020, there was no trigger in our reporting system to send a new notice in Spring 2021—which meant that many women had not seen or heard from us in nearly two years. Additionally, this spring there were just a few new patients. Normally, Logan Health sees an influx of new patients each year who are entering into recommended screening age and beginning their annual mammography routine. The summer volumes followed this pattern and continued to be sluggish.
“There was clearly a problem and we needed a solution quickly,” shared Melissa Kaptanian, MD, breast surgeon at Logan Health. “A pandemic doesn’t stop breast cancer, it still exists even if people aren’t looking for it.” With worries about negative outcomes mounting, a team was gathered to come up with a plan.
The team, including representatives from Logan Health’s breast imaging, breast surgery, population health, quality, marketing and scheduling departments, gathered together to discuss what could be done to recapture women who were overdue. The team decided that the most effective way to get patients in for their screening mammograms would be to contact them directly.
First, they created a list of people who were overdue by 2-3 years and called them personally. With the help of population health and scheduling, a list of 2,556 patients was scrubbed, compiled, and called by mid-July 2021. The team was able to connect with 385 patients, getting them scheduled and back on track with their annual screenings. In addition to the phone calls, the radiologist assistants in the mammography department created a letter to remind those patients that had not yet returned that they were overdue for their annual screening. So far, 589 letters have been sent and about 30 already scheduled.
One of the women that was called mentioned that she would have continued putting off her screening had she not gotten the call. She later learned that she had developed cancer and is currently in treatment at Logan Health. “It would have been a different story had she waited another year,” Dr. Kaptanian explained. “She was so grateful to have gotten the phone call, as it may have entirely altered her life. It showed her that Logan Health and her medical team really cares about her and are willing to go the extra mile.”
The overdue reminder letters and calls are great examples of the ways Logan Health is ensuring women get their important screening mammograms. But, those measures alone are only part of the hard work that has been done to reduce barriers for this service.
Since mammography availability was restored in October 2020, Logan Health has consistently added measures to make the service more accessible. Patients now can access mammography in Kalispell on a walk-in, no appointment necessary basis. They are able to self-refer, allowing women who may not have regular doctor’s appointments, to receive screening mammograms. Appointments are now available during lunch hour, on Saturdays, and can be scheduled online. Logan Health has a mobile mammography unit, The Winkley Mobile Mammography Coach, which travels through rural Montana 19 days a month. Insurance plans cover 100% of the cost of screening mammograms, and if someone is uninsured, Save a Sister, a partnership between Logan Health and Flathead City-County Health Department, is here to help them pay.
Through these efforts Logan Health hopes to reach many more women who are past due for their screening mammograms. The goal is to make every mammography appointment convenient, quick and as comfortable as possible. “The mammography techs and I have received many thanks from patients about reminders to come in and appreciation for how easy we’ve made it,” says Holly Apple, CRA, RT (R)(M)(BD), Logan Health’s lead mammographer. “By taking time to make those personal calls, we are able to make people feel like they’re not just a number to us. We really do care about each one of them and about the health of our community.” None of this would be possible without the exemplary experiences and care given by our mammography technologists, the fantastic integrated teamwork between departments, and Logan Health’s commitment to putting patients first.
If you or someone you love is past due for their screening mammogram please take the time to be screened as soon as possible. Early detection saves lives. Too often women let their own health care fall to the wayside, as they take care of others. By reminding someone, you may change their life. We hope you will join us in asking your loved ones if they have gotten their annual screening mammogram this October.
Visit logan.org/breasthealth for more information about Logan Health’s breast health program.
Written By: Holly Apple & Mady Rigg