Computerized follow-up of abnormalities detected at mammography screening

Obtaining follow-up information after abnormal interpretations is an important aspect of a mammography practice, but it can be tedious, time-consuming, and produce suboptimal results. This study demonstrates the effect of computer-generated reminders on the collection of follow-up data for patients in whom abnormalities were detected at mammography screening. From April 1985 until December 1987, follow-up data for 1009 abnormal examinations were collected by using standard procedures, supplemented by occasional searches of pathology records and sporadic letters and telephone calls to referring physicians. Results showed that follow-up was limited to a normal physical examination in 104 women (10.3%); eight other women (0.8%) were lost to follow-up. For over 90% of these inadequately followed cases, referring physicians were first contacted more than 3 months after screening. Since December 1987, follow-up data for 777 abnormal examinations were collected, supplemented by computer-generated reminders sent to referring physicians for cases apparently unresolved 3 months after screening. Only four (0.5%) of these women have had inadequate follow-up (normal physical examination alone). We conclude that use of a computer-generated reminder system prompts more timely and more appropriate patient management. It also makes follow-up data collection much less onerous.