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News & Press: MPCA News

Community Health Centers Provide Early Detection and Screening Services for Breast Cancer

Tuesday, October 16, 2018  
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October isn’t just decorative gourd season — it’s Breast Cancer Awareness month. The “go pink” initiative is one of the most successful awareness campaigns in existence, and for good reason. About one in every eight women will develop invasive breast cancer. In fact, for women in the U.S., breast cancer death rates are higher than those for any other cancer, besides lung cancer.

 

So what’s actually being done to help more women catch malignancies earlier?


Although breast cancer isn’t wholly preventable, we do know that maintaining a healthy weight, staying physically active, eating nutritious foods, limiting alcohol, quitting smoking, breastfeeding, and reducing the duration of hormone therapy can reduce someone’s risk. However, individuals in underserved communities often face a number of systemic challenges that may make it difficult, or even impossible, to manage their risks and access timely care. As a result, early screening and detection becomes incredibly important.

Fortunately, there’s a massive primary care network that’s specifically built to address the needs of the most vulnerable: America’s health centers. That’s where the Community Health Worker Cancer grant comes in. The grant, funded by the Centers for Disease Control and Prevention (CDC) and overseen by the Michigan Department of Health and Human Services (MDHHS), aims to help organizations increase breast and cervical cancer screening rates.

As part of that grant, MPCA works with quality improvement teams at Advantage Health Centers and Baldwin Family Care. Every two months, the MPCA team meets with each health center to obtain updates on their workflows and identify successes and areas of improvement. Both teams have been working hard on prevention through education and raising their screening rates with evidence-based interventions (EBIs), which include client reminders, provider reminders, reducing structural barriers, and provider assessment and feedback.

Client reminders include anything that will assist the patient in creating an appointment, showing up to their appointment, and maintaining contact between patient and provider for any follow-up that is necessary. Provider assessment and feedback focuses on clinic systems that track provider progress, such as an IT system that reports the percentage of the provider’s patients in the screening cohort who are eligible for screening against those patients who have received a screening in the last 12 months. Providers in one clinic would then be able to compare their report cards and share successes.

Reducing structural barriers encompasses any barrier to screening that a patient may face, such as language barriers, transportation issues, and accessibility to the health center. An example of reducing a barrier could be having translators available or having a driving service and/or bus passes available for those patients who cannot get to the clinic on their own.
Each health center chooses the EBIs that best suit their patient population, and they actively use health information technology, such as their electronic health records, to identify patients for screening. The results speak for themselves.

At Baldwin Family Care, breast cancer screening rates have increased by more than 10 percent in the last quarter. Their team uses their patient portal to send targeted follow-up requests and appointment reminders. Internally, their team maintains a whiteboard displaying each provider’s screening rates, which not only serves as provider assessment and feedback, but also promotes sustained awareness. Onsite mammography has also helped reduce transportation and scheduling barriers.

Because their patients have always faced transportation and language challenges, Advantage decided to work on reducing structural barriers. Their team has taken steps to bolster health education, improve screening availability, establish community partnerships, and help patients get to and from appointments. In addition, they’re piloting a text message system for client reminders, which will improve patient communications beyond the scope of the grant. Advantage started halfway through the grant year, which means they are still gathering data on program effectiveness, but there are more than 330 women are within the target age range (50–74) for the project.

The grant runs until Sept. 30, 2020, and will generate powerful lessons learned for other health centers hoping to increase screenings and help more patients access the care they need. To learn more contact Nina Lavi-Hoke at nlavi@mpca.net.


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