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Association of Electronic Self-Scheduling and Screening Mammogram Completion.

Kimberly J Waddell1, Keshav Goel2, Sae-Hwan Park3

  • 1Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia, PA; Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia, PA; Corporal Michael J. Cresencz VA Medical Center, Philadelphia, PA.

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Electronic health record (EHR) self-scheduling significantly increased mammogram completion rates for eligible primary care patients. This digital tool offers a scalable solution to improve preventive cancer screenings.

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Area of Science:

  • Health Informatics
  • Preventive Medicine
  • Oncology Screening

Background:

  • Screening mammograms are crucial for early breast cancer detection.
  • Improving patient access to preventive services is a public health priority.
  • Electronic Health Record (EHR) patient portals offer potential for enhanced healthcare management.

Purpose of the Study:

  • To assess the impact of an EHR self-scheduling function on mammogram completion rates.
  • To evaluate the association between EHR self-scheduling and screening mammography uptake among eligible primary care patients.

Main Methods:

  • Retrospective cohort study utilizing a difference-in-differences design.
  • Analysis period: September 1, 2014–August 31, 2019 (analyses in 2022).
  • Compared mammogram completion rates before and after EHR self-scheduling implementation, differentiating between active and inactive patient portal users.

Main Results:

  • Overall mammogram completion increased from 22.2% to 49.7% post-implementation.
  • EHR self-scheduling was significantly associated with a 13.2 percentage point increase in mammogram completion for active portal users.
  • A 14.7 percentage point increase in completion was observed for patients with a clinician order who used self-scheduling.

Conclusions:

  • EHR-based self-scheduling effectively boosts mammogram completion among primary care patients.
  • Self-scheduling presents a cost-effective and scalable method for enhancing cancer screening rates.
  • Integrating self-scheduling into EHR systems can improve adherence to preventive care guidelines.