Special Interest Mobile Healthcare: Mammography

Mammography is one of the most effective methods for the early detection of breast cancer, yet many women do not get mammograms. Mammography mobile clinics offer quicker and more convenient access to screening, especially the poor and rural dwellers, who are both most needy and least likely to have access to healthcare.

Goals

Ensure that women are receiving mammograms for their overall breast health.
Support education, prevention and research through a public health approach.
Serve as a solution to health disparities by linking multidisciplinary services that improve the wellbeing of the population served.

Considerations

Type of treatment: Breast cancer screenings for the underinsured and uninsured.

Reading the films: There are generally two approaches:

In-house radiologists, who are “attached” to the facility that owns and operates the mobile program.

Outside contract radiologists, who are contracted with the facility that owns the mobile program (to read images and participate in quality initiatives).

Staffing: For one program the on-vehicle staff includes a radiologist, mammography manager (who oversees the screening staff and vehicle management), mammography technologist, van registration clerk (who verifies insurance, scans documents and controls receipt of prescription, patient demographics, HIPAA documents and satisfaction surveys), driver (maintains vehicle) and mammography screening coordinator (coordinates schedules, result letters, appointments and tracks abnormal results).

Costs: Depending on type of vehicle, specifications and equipment, average costs can range from $250,000 to $1,000,000, plus equipment and operational budgets.

Equipment: The three leading manufacturers of imaging equipment are GE Health Systems, Hologic (FDA-approved for 3D digital breast tomosynthesis) and Siemens.

Grants: Many programs are funded by well-known grantors, including Susan G. Komen for the Cure, Avon Foundation, National Breast Cancer Foundation, Breast & Cervical Cancer Programs, Safeway, Breast Cancer Relief Fund, as well as local hospital foundations.

Billing: Depends upon the mobile clinic infrastructure, licensing category and mission. One possible option is to bill mammograms as “global”, both professional and technical, under one charge. If your program is hospital-affiliated, bill as a hospital charge. When reimbursement is received, radiologists receive a percentage of payment. Set up separate insurance codes to identify the uninsured (covered by mammography van), those paid by sponsor and those who are covered by grants.

Data collection: Essential to maintaining funding support and to comply with grants. Should include patient demographics and health history, as well as mammography reporting, i.e., customized forms, IT capability and software systems. (Most radiology information systems have a mammography module that serves as the data depository for reporting follow-up and quality audits. The three leading systems are MagView, MRS, PenRad).