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Keep mammogram outreach well-organized
Although it is difficult to determine the exact financial impact of mobile mammography units, there is a tremendous difference in the cost of treating early-stage breast cancer vs. late-stage cancer.
"We can treat early-stage breast cancer for $6,000 to $8,000 maximum, and late-stage breast cancer for $150,000 to $200,000, so mammograms save companies money," says Vera Garofalo, MT, director of mammography services at The Ohio State University Medical Center, Arthur James Cancer Hospital and Research Institute in Columbus. Also, women miss very little work with a mobile unit, because they can be in and out of the van in 10 minutes.
While beneficial, mobile sites must be well-organized to work as an effective outreach tool. In particular, scheduling must be well-planned. "Initially, we had the sites schedule the mammograms, but we found that by the time the van would show up we had either too many patients or none. Therefore, we increased our clerical staff, and with the exception of a handful of senior centers, everyone calls directly through us," says Kate McKenzie, RN, program manager for Mammography of Delaware in Wilmington.
Businesses and organizations that schedule a time for the mobile unit to come to a site are sent a kit that has all the information they will need to promote the program. Included is a sample letter to be used as a blueprint to inform women about the screening and how to sign up. Also, everyone who has had a mammogram through the mobile unit is in the computer system and automatically receives a card each year to remind them to get their annual mammogram.
"We have to have a minimum of 25 appointments to come to a site. Therefore, we use our appointment line to keep track," says Karen Spears, LVN, mobile screening coordinator for the University of Texas MD Anderson Cancer Center in Houston. Companies usually e-mail a notice to all employees with the date of the screening and the telephone number of the appointment line.
A good tracking system of previous mammograms is needed as well, because one of the benefits of having annual mammograms is comparing results from year to year, says Garofalo. "A downside to mammography, and it has nothing to do with mobile, is that women choose to go to different locations," she says. They often have their mammograms at varying locations because their insurance coverage changes or they switch physicians.
Therefore, if a woman’s past films need to be viewed, staff go on a search mission. They call the patient's physician and other mammogram sites to find the film. If the film cannot be found, the woman is asked to come in to the medical center’s comprehensive breast center for additional X-rays with varying views. "We can still make a complete assessment if we can’t get the previous films to compare," says Garofalo. When there are problems, results are immediately faxed to a woman’s physician and the radiologist calls him or her.
It is often easiest to work with companies if rules are not set in stone, says McKenzie. For example, one company asked that only one employee from each department be at the van at the same time. Therefore, when employees from that company called to schedule an appointment, the clerks were instructed to ask what department they worked in first. "We customize our process for each site," says McKenzie.