JMIR Publications

ABSTRACT

Background:

Screening mammography is recommended for the early detection of breast cancer. Processes for ordering screening mammography often rely on a health care provider order and a scheduler to arrange the time and location of breast imaging. Self-scheduling after automated ordering of screening mammograms may offer a more efficient and convenient way to schedule screening mammograms.

Objective:

To determine the use, outcomes, and efficiency of an automated mammogram ordering and invitation process paired with self-scheduling.

Methods:

We examined appointment data from 12 months of scheduled mammogram appointments, starting in September 2019 when a web and mobile app self-scheduling process for screening mammograms was made available for the Mayo Clinic primary care practice. Software processes were utilized to identify and invite patients for recommended mammograms. Patients registered to the portal (access to Mayo Clinic Patient Online Services) could then go online or via mobile app, view Mayo Clinic mammography schedules, and book their mammogram appointment. The self-scheduling process was completely automated and required no telephone calls or staff appointment schedulers. We examined uptake (count and percentage of patients utilizing self-scheduling), numbers of appointment actions taken by self-schedulers and staff schedulers, no-show outcomes, scheduling efficiency and weekend and afterhours use of self-scheduling.

Results:

For those patients who had Patient Online Services (POS), 15.32% (14,387/93,901) used the web or mobile app to do either some self-scheduling or self-canceling appointment actions. Patients self-scheduling appointment actions occurred afterhours or on weekends 24.42% (3285/13,454) of the time. There were 9.30% (8736/93,901) who used self-scheduling/canceling exclusively. For self-scheduled mammograms, there were 5.68% no-shows (536/9433) compared to 4.63% no-shows (3590/77,531) in staff-scheduled, not statistically different in an age adjusted model (P=.071). On average, there were only 0.196 staff-scheduler actions for each finalized self-scheduled appointment, so staff-schedulers were rarely used to redo or “clean up” self-scheduled appointments. Exclusively self-scheduled appointments were significantly more efficient than staff-scheduled, with multiple appointment steps to achieve a finalized mammogram only needed in 6.51% (526/8079) of self-scheduled appointments compared to multiple appointment steps needed in 25.46% (18035/70839) of the staff-scheduled appointments (P<.0001).

Conclusions:

Mammograms can be efficiently self-scheduled by many patients, without a significant impact on no-shows. Self-scheduling can decrease staff-scheduler work and can be convenient for patients who want to manage their appointment scheduling activity afterhours or on weekends.