When the pandemic hit in March 2020, most health systems put a pause on elective procedures and annual breast cancer screenings to keep healthy patients out of their facilities, prioritize treating COVID patients, and slow the virus’ spread. This included postponing mammograms scheduled in the early months of the pandemic.
The number of cancer screening tests received by women through the CDC National Breast and Cervical Cancer Early Detection Program declined by 87% for breast cancer during April 2020 compared with previous five-year averages. Additional data from Epic Health Research Network – which collected numbers from 60 healthcare organizations representing 10 million women – found about 50% of women scheduled for a routine mammogram missed their appointments and 25% of women postponed care for breast cancer symptoms, resulting in delayed diagnoses and treatment.
While both routine mammograms and diagnostic mammograms have largely rebounded, healthcare organizations are now seeing the ramifications from postponed preventive screenings and necessary exams, including later stage diagnoses and a surge in cancer rates. Modeling data from the National Cancer Institute “indicates that last year’s drop in testing for breast and colorectal cancers alone will lead to 10,000 deaths over the next decade,” according to NPR.
The pandemic is one of many barriers to getting all eligible women routinely screened for breast cancer and receiving other necessary healthcare services. Before the pandemic, 61% of women ages 50-74 with no health insurance had not had a mammogram, as were 25% of women with health insurance in the same age bracket. Those rates continued to climb during the pandemic.
On the heels of Breast Cancer Awareness Month, we’re highlighting the importance of getting women back on track with regular mammograms.
Changing Barriers to Care
Your patients face a host of both external and internal barriers that keep them from scheduling and showing up for mammogram appointments — barriers that can change unexpectedly.
Some external barriers, like the pandemic, impacted everyone regardless of life circumstances. Dynamic changes in COVID-19 regulations and prevention protocols impacted everyone’s perceptions of and interactions with the healthcare system. The recent Delta surge made providers less available, some infected with COVID-19, and patients having to reschedule and reassess risk levels .
There are other types of barriers. These can be cognitive (e.g. defaulting to the status quo of not getting care), psychosocial (e.g., being misinformed, fatalistic), physical (e.g., having a disability) or due to life circumstances (e.g., experiencing a job change, health plan change, and other social determinants of health [SDOH], like no transportation, no work flexibility, and no Internet access). As the environment and people change, these barriers, too, change over time, dynamically impacting whether a patient does a health screening.
Dynamically addressing each person’s specific barriers and communicating uniquely via their preferred communication channel is paramount to move each person towards critical preventive screenings. The delays in care due to the pandemic have created even more urgency.
Research published in the March 29, 2021 issue of the Journal of the National Cancer Institute shared preliminary results from University of Wisconsin Cancer Intervention and Surveillance Modeling Network (CISNET). Their breast cancer model estimated that 75% fewer screenings over six months, and a six-month delay in diagnosis for one-third of women with an abnormal result or clinical symptoms, would result in over 5,000 excessive breast cancer deaths (a 1% increase) in the United States between 2020 and 2030.
You and your patients can’t afford to wait any longer. Now is the time to effectively communicate with them about the importance of receiving preventive care, getting back on track and maintaining a routine cadence.
Keys to Responsive, Hyper-Personalized Communication
To effectively address your patients’ changing barriers to getting care, you need a seamless, nimble, scalable communication method tailored to each patient.
Here are a few keys to overcome your patients’ current barriers and get them routinely screened.
1. Understand What Makes Your Patients People
Patients’ reasons for not scheduling or not showing up to a mammogram appointment are vast and varied – and often unrelated to their medical conditions. Understanding your patient population is key. Collecting SDOH data and identifying common cognitive biases and barriers affecting patients’ decisions and behaviors is a critical step to promoting preventive care.
With this understanding, you can develop messages that speak to your patients’ entire personhood, focusing on what keeps them specifically from scheduling and attending appointments. Lirio’s platform translates this data from your systems of record to your systems of engagement, serving as an intelligence layer that makes meaning out of patient information.
This hyper-personalized approach can help reduce disparities that have occurred in women’s health screenings. Compared to July 2012, in July 2020, breast cancer screening rates were only about 7% lower for white women and 3% lower for Black women, but still 27% lower for Hispanic women and 49% lower for Asian women.
2. Create a Sense of Urgency
Your organization needs to prioritize communicating with patients who were already overdue for mammogram appointments before the pandemic – they have gone way too long without a screening. Knowing they may have personal hesitations, start pushing them toward scheduling a mammogram now and emphasize the urgency of their situation. You can then create target timelines that account for potential delays.
The messages sent should address identified cognitive biases and overcome psychosocial and SDOH barriers to screenings. The Lirio behavior change AI platform accounts for all of this. It is built with behavioral science and incorporates tailored behavioral interventions that address cognitive biases and overcome each person’s barriers.
By developing hyper-personalized messages for the overdue group of patients, and deploying them at scale, you can move them to take the right action quickly and re-engage or maintain their engagement in preventive care.
3. Continue Learning about Your Patients
COVID-19 taught us life and our health can always change – and often without warning. Your communication methods must respond quickly when change happens. One way to stay on top of change is by continuously learning about your population and what factors play into each individual’s healthcare decisions and actions.
With this active knowledge about your patients, you can adjust your communication accordingly to ensure your messages resonate with them. The Lirio platform helps you do this through continuous learning. It gets smarter over time, learning which behavioral interventions work for each person. The platform then makes adjustments based on recipients’ interactions and responses.
Dynamic message optimization and flexibility ensures you don’t get caught off guard when your patients inevitably experience new barriers to care.
Lirio’s Precision Nudging Solution for Mammograms
To help healthcare organizations increase women’s health screenings, Lirio offers a Precision Nudging™ solution that moves patients to schedule and attend mammogram appointments.
Precision Nudging – the application of tailored behavioral science solutions to overcome patient-specific barriers to action at the right time and place – works to help your patients achieve scalable, sustained behavior change. The result is a more engaged patient population and improved health outcomes overall.
Learn more about how Bon Secours Mercy Health leveraged the Precision Nudging solution for mammograms during our upcoming webinar, “Beyond October—Building Patient Trust and Engagement with a Year-Round Mammography Strategy,” on November 9 at 12PM EDT.
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