Breast Cancer Work Group Meeting | September 13, 2016

Attendees: Penny Jones – St. Bernard’s Healthcare, Julie Adamson – St. Bernard’s Healthcare, Sharp Malak – Mobile Mammography UAMS, Carrie Cochran-Raglon – Mobile Mammography UAMS, Marisa Nelson – ADH, Debby Harris – Breast Care NWR, Carolyn Garrett – CARTI, Joan Diehl – Community Health Center of AR, Amanda Roberts – White River Medical Center

ACC: Kimberly Enoch-Noble, Myca Grant

Updates from Work Group Members:

  • Dr. Malak stated that he sent a book to 1600 primary care physicians in Arkansas called "Understanding the Breast in Health and Disease" by Laszlo Tabar. In addition, UAMS sent information to all 2800 primary care physicians regarding county specific data about in-situ, invasive, late stage cancer, and screening rates. Dr. Malak was able to contact some hard-to-reach populations. He stated that we need to work on reaching the Delta region.
  • We need to work on targeted marketing materialsto share with primary care providers.
  • Joan and Debby suggested working more with community health centers.
  • Kim suggested thegroup work on a one year plan andaddress the gaps. There are a lot of women in Arkansas who need to be screened. Does mobile mammographycover the areas without coverage? What is a good way to get women into screening programs and expand scope to underserved?
  • Dr. Malak suggested the one year plan include only working on mobile units and digital conversion.
  • South Arkansas may have a capacity issue. Dr. Malak shared that the UAMS MammoVan does go to South AR.
  • Debby Harris said that the mobile van that used to be in Springdale is now in Bentonville. They would not come to a mass flu shot clinic without women being already on the schedule. St. Bernardsand UAMS do not require a schedule before attending an event. Dr. Malak offered to call Mercy and speak with them. Mercy only has one person available to control the van.
  • Joan asked if the UAMS MammoVan had a fixed schedule. Dr. Malak answered and said no, they only schedule two months in advance. He would like to change that. They go to events when they are invited.
  • St. Bernards has a yearly schedule. Randolph and Clay counties do not have fixed units, so St. Bernards goes there on a regular schedule.
  • Joan says community health workers have difficulties getting the report back to the primary care provider and into the electronic medical records. If the patient lists a primary care provider, the UAMS MammoVan faxes the report to the primary care provider. However, sometimes the patient does not supply one, or provides an inaccurate one. St. Bernards also faxes the reports but they require a physician to receive the screening.
  • The work group needs to meet monthly, even if it is just a conference call.

Mammography Facilities, Digital vs Film 2016 map

  • The map is of Arkansas’ mammography facilities illustrating which facilities are converting from analog to digital. Kim questioned if this is an accurate representation of all of the FDA-approved mammography facility and whether it accurately depicts the number converting and those not planning to go digital. ACC suggests a survey of these facilities to determine barriers to digital conversion and current plans for the existing four which are planning to go digital.
  • ACC can act as a neutral player to reach out to hospitals and mammography facilities to address gaps and facilitate collaboration and partnership.
  • Losing facilities is a major problem and the map shows that Arkansas currently has a capacity issue.
  • The digital conversion for mammography units is required by 2017. Per Centers for Medicare and Medicaid Services, everything will be digital.
  • Stone County has a digital machine. The transition went well. They were able to increase screening rates. Sharp County will be making the change soon. There is a lot of expense needed to convert a fixed unit from analog to digital and it requires a lot more staff.

Survey:

  • Suggested topics for developing questions:
  • Differentiate between mobile capacity and fixed building capacity.
  • Determine capacity of mammography facilities and know who to refer patients to, based on location.
  • Address requirements for each mobile unit and free-standing facility regarding turn-around for reporting
  • The survey should be separate for FDA-approved facilities and mobile units.

Action items:

  • Develop a surveydraft of items for mobile units and fixed mammography units – request feedback from work group members for additional items and questions.
  • Create a comprehensive schedule to display all mobile units in the state:
  • Contact all mobile units in the state.
  • Develop a survey draft to determine barriers to mammography digital conversion and current plans for the existing four that are planning to go digital.
  • The next meeting will be in mid-October. ACC will send a Doodle poll to check for the best meeting time and plan recurring meetings.

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