Breast Cancer Screening and Follow-up in a PBRN: The Ma*

Summary

Principal Investigator: M J Barry
Abstract: [unreadable] DESCRIPTION (PROVIDED BY APPLICANT): University of Arizona, Sarver Heart Center Health care organizations play a central role in improving the process of breast cancer screening and follow-up. For patients receiving regular care within a medical system, sub-optimal mammography screening rates represent a significant system-level failure in care delivery. Research efforts to overcome barriers to screening success and effective follow-up must therefore move from an exclusively patient or physician focus to include the process of care delivery within health systems. Because primary care providers (PCPs) are the key decision makers in a practice network, we hypothesize that correctly classifying patients based on linkage to a specific PCP will create a mechanism to efficiently allocate resources and interventions to change care. For patients with a close PCP linkage, interventions to improve mammography screening rates can be focused through the physician, whereas for patients who receive care (often episodic) from within the system but without close linkage to a PCP, interventions can be directed through a practice manager. We propose to closely couple identifying the right provider for a patient to the use of clinical health informatics systems that link information to action and that can be easily used independent of clinic visits to enhance primary care cancer screening. We will implement an informatics-based population management tool for use by PCPs or practice managers in a controlled trial within our Practice-Based Research Network (PBRN). Specific Aim 1: To classify all patients within the MGPC-PBRN according to patient-PCP linkage status and to describe the characteristics of patients with close linkage to a PCP ("PCP loyal") or not ("Practice loyal"). Specific Aim 2: To develop and implement a novel breast cancer screening intervention program called Mammography FastTrack to facilitate ordering and tracking of mammograms that can be used by either PCPs (for PCP-loyal patients) or by practice managers (for practice-loyal patients). Specific Aim 3: To perform a group randomized trial of the Mammography FastTrack program within the MGPC-PBRN to increase mammography screening rates in both PCP-loyal and Practice-loyal eligible patients overdue for breast cancer screening. This research is relevant to nationwide efforts to modernize and improve health information technology capabilities. We will create a process to track all patients within our PBRN and to reduce current barriers to ordering and following up of abnormal mammogram results. [unreadable] [unreadable]
Funding Period: 2006-03-01 - 2009-02-28
more information: NIH RePORT

Top Publications

  1. pmc Population-based breast cancer screening in a primary care network
    Steven J Atlas
    General Medicine Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
    Am J Manag Care 18:821-9. 2012
  2. pmc A cluster-randomized trial of a primary care informatics-based system for breast cancer screening
    Steven J Atlas
    General Medicine Division, Massachusetts General Hospital, Harvard Medical School, 50 Staniford Street, Boston, MA 02114, USA
    J Gen Intern Med 26:154-61. 2011
  3. pmc A culturally tailored navigator program for colorectal cancer screening in a community health center: a randomized, controlled trial
    Sanja Percac-Lima
    Chelsea HealthCare Center, Massachusetts General Hospital, Chelsea, MA 02150, USA
    J Gen Intern Med 24:211-7. 2009
  4. pmc Patient-physician connectedness and quality of primary care
    Steven J Atlas
    Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
    Ann Intern Med 150:325-35. 2009

Scientific Experts

Detail Information

Publications4

  1. pmc Population-based breast cancer screening in a primary care network
    Steven J Atlas
    General Medicine Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
    Am J Manag Care 18:821-9. 2012
    ..To assess the ability of a health information technology system to facilitate population- based breast cancer screening...
  2. pmc A cluster-randomized trial of a primary care informatics-based system for breast cancer screening
    Steven J Atlas
    General Medicine Division, Massachusetts General Hospital, Harvard Medical School, 50 Staniford Street, Boston, MA 02114, USA
    J Gen Intern Med 26:154-61. 2011
    ..Information technology offers the promise, as yet unfulfilled, of delivering efficient, evidence-based health care...
  3. pmc A culturally tailored navigator program for colorectal cancer screening in a community health center: a randomized, controlled trial
    Sanja Percac-Lima
    Chelsea HealthCare Center, Massachusetts General Hospital, Chelsea, MA 02150, USA
    J Gen Intern Med 24:211-7. 2009
    ..Minority racial/ethnic groups have low colorectal cancer (CRC) screening rates...
  4. pmc Patient-physician connectedness and quality of primary care
    Steven J Atlas
    Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
    Ann Intern Med 150:325-35. 2009
    ..Among all patients seen by a physician, some will be more strongly connected to their physician than others, but the effect of connectedness on measures of physician performance is not known...