October 19, 2016 — Centers that perform mammograms in the United States know their job doesn’t just stop at delivering results to the referring physician. Mammography is regulated by the government and centers need to adhere to the rules for breast cancer tracking and reporting in the Mammography Quality and Standards Act (MQSA). This means a more personal relationship with the mammography patients is necessary, as the center is responsible for providing each patient’s results and ensuring each patient has the required follow-up exams. This is a timely endeavor, and without a streamlined solution to help with breast cancer tracking and reporting, patients can get lost when waiting for priors or follow-up exams, causing centers to fail their annual MQSA audits. I recommend selecting a solution that will automate breast cancer tracking and reporting to improve patient care, while cutting costs and saving time. With that said, below are five changes you can make to improve breast cancer tracking and reporting within your facility.
1. Patient Questionnaires, Technologist Forms, and Radiologist Data Sheets
Everything from questionnaires to tech and radiologist forms should be completed electronically and stored within the patient’s chart. This information should also auto-populate each of the forms that need to be completed in the future for your workflow, including the BI-RADS [Breast Imaging Reporting and Data System] letter to the patient and the results to the referring physician.
2. BI-RADS Atlas and Clinical Information
Capturing the BI-RADS data, recording clinical information and producing a report that relays these findings to your referring physician saves time, so that referrers know what to look for and where they can spend more time communicating the results to the patient. I highly recommend a system that includes the information in the ACR BI-RADS Atlas to help with your breast cancer tracking and reporting. Making things easier for your radiologists and referrers doesn’t mean you don’t care about your patients, it means you care about spending more time with your patients by cutting down on paperwork.
3. Patient Letters by Category and Facility
Patient letters are extremely important in breast cancer tracking and reporting. They’re very personal to your patients, but this doesn’t mean you shouldn’t have a way to automate both the reminders and the results. Your breast cancer tracking system should enable you to run patient letters by category and facility with just a few clicks to help save time with the folding of the letters, stuffing envelopes and mailing.
4. Single Reporting Module and Image Storage
Centers that perform mammography often have separate systems for radiologists to dictate breast studies and another to read breast studies on. These are separate of their RIS [radiology information system], PACS [picture archiving and communication system] and/or normal reporting module. I’m not sure why centers feel the need to have so many disparate systems, except that they believe each is the best, or there are limited funds to switch. I caution you, using disparate systems is how images and data get lost. Having one integrated product with one database for all of your image storage, reports, dictations, patient forms, etc. will prevent this from happening.
I worked for an imaging center where the tech pushed the mammo to the reading system (our normal workflow). One patient needed follow-ups, but the original mammo was somehow lost from the reading station, never made it to our central repository and was no longer on the modality, so the exam hung out waiting to be read. Meanwhile, the patient passed away from breast cancer while waiting for the comparison to be read. This was tragic to me and I cried along with many of my coworkers. I can’t say whether the outcome would differ if the exam had been read in a timely manner and the prior mammo had never been lost, but this tragedy will trouble me forever. Why and how we ever let this mammo get lost and how it failed to make it to our central image repository has pained me to this day.
When pushing from modality to reading station, without a central database that stores everything (with a redundant server in the mix), tragedies like these can and do occur every day. This is why I’m a huge advocate for using a single database system for your breast cancer tracking and reporting.
5. Single Database RIS/PACS and Mammography Tracking
I’m being redundant, but this is because of the importance of having a streamlined system. A single platform, meaning one database and one software that everyone uses for everything, eliminates the need to utilize a third-party modality worklist, reporting module for business analytics, breast cancer tracking and reporting module, diagnostic reporting module, special reading stations, and offers a streamlined workflow for everyone while cutting hardware costs.
There’s no reason to settle for integrated products — pick one that offers it all, including a breast cancer tracking and reporting module. This way all of your staff can help in the event that your mammography specialist is ill or has a family emergency. With everyone using the same software to perform their daily job functions, they’ll be able to pinpoint who needs a follow-up, if the letters were printed, who needs a letter, etc. The more streamlined a system is, the more streamlined your breast cancer tracking and reporting will be along with your entire workflow.
Editor's note: Erin Martin is a senior HL7 integration specialist at RamSoft, with a focus on RIS/PACS integrated software solutions. Before joining RamSoft in 2006, she was a PACS network administrator for 19 imaging centers in Florida from Jacksonville to South Miami.