title: Mobile mammography: An evaluation of organizational, process, and information systems challenges.
abstract: The purpose of this case study was to evaluate the information systems, personnel, and processes involved in mobile mammography settings, and offer recommendations to improve efficiency and satisfaction among patients and staff. Data includes on-site observations, interviews, and an electronic medical record review of a hospital who offers both mobile and fixed facility mammography services to their community. The optimal expectations for the process of mobile mammography from multiple perspectives were defined as (1) patient receives mammogram the day of their visit, (2) patient has efficient intake process with little wait time, (3) follow-up is completed and timely, (4) site contact and van staff are satisfied with van visit and choose to schedule future visits, and (5) the MMU is able to assess its performance and set goals for improvement. Challenges that prevent the realization of those expectations include a low patient pre-registration rate, difficulty obtaining required physician orders, frequent information system downtime/Internet connectivity issues, ill-defined organizational communication/roles, insufficient site host/patient education, and disparate organizational and information systems. Our recommendations include employing a dedicated mobile mammography team for end-to-end oversight, mitigating for system connectivity issues, allowing for patient self-referrals, integrating scheduling and registration processes, and a focused approach to educating site hosts and respective patients about expectations for the day of the visit. The MMU is an important community resource; we recommend simple process improvements and information flow improvements to further enable the MMU׳s goals.
authors.affiliation: Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, United States.
authors.forename: Casey
authors.initials: C
authors.lastname: Browder
authors.affiliation: Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, United States; Statewide Cancer Prevention and Control Program, University of South Carolina, United States. Electronic address: jmeberth@mailbox.sc.edu.
authors.forename: Jan M
authors.initials: JM
authors.lastname: Eberth
authors.affiliation: Department of Integrated Information Technology, University of South Carolina, United States.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Schooley
authors.affiliation: Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, United States; Statewide Cancer Prevention and Control Program, University of South Carolina, United States.
authors.forename: Nancy R
authors.initials: NR
authors.lastname: Porter
mesh_terms: D001943:Breast Neoplasms; D003142:Communication; D017598:Efficiency, Organizational; D057286:Electronic Health Records; D006751:Hospital Information Systems; D006801:Humans; D020407:Internet; D008327:Mammography; D008952:Mobile Health Units; D009937:Organizational Objectives; D009938:Organizations; D012017:Referral and Consultation
keywords: Breast neoplasms; Early detection of cancer; Mammography; Mobile health units; Quality improvement