• Posted December 15, 2023

One Way to Boost Mammogram Rates: Let Women Schedule Their Own Appointments

Allowing women to schedule their own mammography appointments increases the likelihood they'll follow through on the screening, a new study reports.

“Self-scheduling helps make the path to mammogram completion a little smoother, where you don't have to find the time to call a scheduling line, wait on hold, or go back and forth trying to find an appointment that works for your schedule,” explained lead researcher Kimberly Waddell, an assistant professor of physical medicine and rehabilitation at the University of Pennsylvania.

“Simple changes like these can have an outsized impact on preventive health screenings,” Waddell added in a university news release.

One in every eight women are affected by breast cancer, researchers said in background notes. Mammograms are essential to detect breast cancer early for better treatment, but many women are lax in sticking to screening guidelines.

For the study, researchers analyzed data from 2016 to 2019, when the University of Pennsylvania Health System gave women the opportunity to schedule their own mammograms through their personal online patient portals.

They compared how well that worked to the two years prior to the new system.

In the years before the new system was implemented, patients referred for mammograms received no reminders and had to make calls during regular business hours to schedule their screening.

In the new system, all a patient needs an electronic order from their doctor. They log into their patient portal, click through to a scheduling link, and set up the appointment on their own.

The patients also receive a reminder e-mail message to self-schedule their own mammogram.

These steps are all part of a behavioral science concept called “nudging.” In nudging, health systems make small changes that streamline the ability of people to accomplish desired tasks.

“Self-scheduling functionality provides the right kind of prompt since it allows patients to immediately schedule their screening in just a few steps,” said senior study author Dr. Shivan Mehta, an associate professor of physical medicine and rehabilitation at the University of Pennsylvania. “Removing barriers is key in behavioral science, and we were able to demonstrate the value of it firsthand here.”

Data from about 35,000 patient visits showed that mammogram completions more than doubled overall during the study period, going from 22% to 50%, results show.

Self-scheduling was directly associated with about 13 percentage points of that increase in screening completions, researchers said.

That means that about 4,500 more people finished their screening out of the 35,000 patients.

The findings were published Dec. 11 in the American Journal of Preventive Medicine.

Researchers said they were struck by how a simple and inexpensive change could lead to more screenings.

“Patients want options on ways to schedule their appointment, and the self-scheduling feature provides another, easy 24/7 pathway to schedule when it's convenient to them,” said study co-author Jake Moore, director of access optimization at Penn Medicine.

The researchers now are conducting a clinical trial involving nudges directed at both patients and clinicians to further improve mammogram completions.

They plan to deliver an additional text message nudge to patients in groups that are at higher risk for not completing their mammogram.

More information

The American Cancer Society has more about mammograms.

SOURCE: University of Pennsylvania, news release, Dec. 15, 2023