Breast screening administration - Denmark’s web-based portal

The daily management of around 700 examinations within the national mammography screening programme keeps Dr Ilse Vejborg and her team at Rigshospitalet pretty busy. ‘We have the largest screening unit in Denmark with 200,000 women aged 50-69 years in the target group invited for an examination every second year,’ she explains.

‘The exams take place in five units but are centrally managed in one programme with one secretariat sending out the invitations and scheduling the appointments.’ Dr Vejborg heads the Mammography Screening Programme in the Capital Region of Denmark. Of the country’s five regional health authorities, the Capital Region is one of three that use the Carestream RIS mammography module – the basis for a web-based patient portal that improves the administration of screening appointments.

The RIS enables accurate documentation and reporting of all radiological findings. A set of graphics tools captures patient medical and mammography histories, mammography findings, pathology results, follow-up, patient tracking, and includes an automated radiologist report. The detailed capture screen for patient concerns and procedure information includes a drawing tool that allows technologists to convey visual information to the radiologist, which works
alongside a single PACS.

The Capital Region has five fixed screening sites, at Bispebjerg, Bomholms, Herlev, Hvidovre and Nordsjaellands Hospitals. Double-blind readings are performed at the two university hospitals, Herlev Hospitel and Rigshospitalet where also recall examinations and surgery take place. ‘The evaluations are forwarded electronically via the RIS to the secretariat that is sending out the answering letters as will as invitation, recall and reminder letters’ Dr Vejborg adds.

Before the web-based patient portal was launched, women had to phone the hospital between 8.00 am and 3.00 pm to re-schedule appointments for screening and recall examinations, creating considerable organisational work for the secretary. Dr Vejborg also adds that many women found it difficult to make appointments by phone when at work.

‘The additional administrative burden for the hospital – writing to non-attendees, re-booking and dealing with cancellations – also called for a system that would better suit patients’ needs and save valuable hospital resources.’ Another reason to implement the patient portal was that the three Carestream RIS regions were seeking solutions to improve attendance rates. In collaboration with the three regions the company developed the unique portal, which soon became the most visited healthcare website in the region. The core feature of the portal is a unique password that enables women to enter their personal account and change data. This password is sent together with the invitation, a questionnaire, a leaflet and an explanation how to access the website.

Once the women have entered the portal they can navigate through a simple, intuitive process to modify their appointment time, day or location as often as they want for up to three months. At the same time the portal seamlessly communicates with the hospital RIS to facilitate the booking. All actions are summarised and displayed so that the details can be printed. ‘For us the comment function is very interesting because we receive feedback from the women, such as why they decide against screening, which is very valuable information’, she adds. (Of course, data security is
protected; the entire portal works with a secure line.) Today we see an attendance rate around 75 percent. We have not yet seen any significant change in attendance rate after introduction of the web portal.

Currently, Carestream and Rigshospitalet are developing an online patient questionnaire to be filled in by women rather than the radiographers – another step that should further improve service quality, screening administration and workflow efficiency.

20.10.2011