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October's HRSA Health IT Grantee Spotlight

“Magee General Hospital Meaningfully Using Health IT and Community Outreach to Prevent Breast Cancer in Their Rural Community”

In recognition of National Breast Cancer Awareness Month, HRSA’s Health IT website is highlighting the great work of Magee General Hospital (MGH). This rural hospital’s breast cancer preventive services program utilizes health IT and innovative outreach strategies to improve health care quality and coordinate patient care. MGH’s breast cancer prevention program was made possible through a 2009 Rural Healthcare Outreach Grant from the Office of Rural Health Policy (ORHP). ORHP’s grant allowed MGH to purchase new mammogram equipment, distribute breast cancer education materials, and fund mammograms for uninsured women.  When a patient comes to MGH for breast cancer services , her tests, follow- up care, and all referrals are tracked through MGH’s new electronic medical record (EMR) system. As a result, MGH’s breast cancer preventive program has a tremendous impact on its rural community and has resulted in saving the lives of many women.

Breast Cancer in Rural Environments

According to the National Cancer Institute (NCI), in 2011 there were 230,480 new cases of female breast cancer diagnoses and 39,520 deaths from breast cancer. Women in rural environments are especially challenged with seeking timely breast cancer preventive care. Some reasons for this include:

• Poor access- rural residents have to travel long distances to see specialized clinical staff with mammography equipment essential for the detection and treatment of breast cancer.

• High poverty rates and lower income levels- Rural patients are more likely to be low income and under-insured which minimizes patients’ access to education on breast cancer prevention and treatment programs.

According to the Rural Assistance Center, a rural patient’s lack of access to cancer preventive services results in later stage cancer diagnoses, causing higher cancer mortality rates among rural residents.

About Magee Hospital and its Breast Cancer Prevention Program

MGH is 64-bed rural hospital founded over 70 years ago in Southcentral Mississippi. MGH offers state-of-the-art technology and comprehensive medical care ranging from prenatal through elder care services to a six county service area.

Upon receiving their ORHP grant, MGH built a breast cancer prevention program that combines innovative outreach to the community and the use of health IT for the coordination of preventive services and follow up care. These aspects are important for overcoming the barriers that rural patients endure in accessing high quality breast cancer preventive services and follow up care. From the beginning MGH set high goals for this program including:

• Provision of 500 free mammograms during the 3-year grant period;|

• Distribution of 3,000 education materials on breast cancer;

• Establishment of an innovative partnerships with community and cancer groups to support  outreach to rural and minority groups; and

• Establishment of a mechanism for follow up care.

Through tracking these goals, MGH was able to measure their success and identify opportunities for improvement.

Innovative Outreach to the Community Through Faith Based Organizations

MGH worked with the Susan G. Komen  Foundation to secure breast cancer education materials tailored for their rural and minority patients. In addition, MGH anticipated the need to establish innovative partnerships to help target at risk patients in the community. According to MGH’s Grant Administrator, Ms. Cindy Watkins:

“Statistics show that 1 in 8 women will receive a breast cancer diagnosis.  According to Susan G. Komen for the Cure, mortality rates after a breast cancer diagnosis are higher for minority women because of late stage diagnosis.  Studies have shown that barriers to access to quality care are largely responsible for this rate.  Our program seeks to reach those women and get them screened as early as possible.”

MGH formed partnerships with the community’s minority churches to help facilitate breast cancer education seminars for church members of all ages. In these seminars, MGH staff worked with clergy to provide the following breast cancer preventive services:

• Patient self-testing demonstrations

• Breast cancer education materials

• Frequently asked questions and answers to clinical questions

• Speakers including  breast cancer survivors and MGH clinicians

• Sign-ups for free mammograms.

Ms. Watkins states that “these seminars have been highly effective in educating ladies within these minority churches on the importance of breast cancer prevention and awareness.” Since breast cancer can be a taboo subject in rural and minority communities, MGH knew partnering with the churches in the community was important for patients to receive this information in an environment where they felt safe.

Diane Myers, Mammographer, using breast models and explaining breast self-exams to Breast Cancer Awareness Seminar attendees.

MGH’s Digital Mammogram Machines

MGH’s grant from ORHP also enabled the purchase of a new digital mammography machine, which allow clinicians to take digital, high resolution x-rays that help detect cancer early. The Centers for Disease Control recommends that women age 50 or older should have mammograms every 2 years. MGH’s free mammograms have been critical for expanding access of these preventive tests among the uninsured and minorities within their community and have detected many early cases of breast cancer.

Meaningfully Using Electronic Medical Records for Care Coordination and Improving Quality

Once a patient comes to MGH for breast cancer preventive care services, her information is entered into MGH’s Electronic Medical Record (EMR) system which helps the hospital coordinate care throughout its facility. MGH recently qualified for Meaningful Use Stage 1 of Center’s for Medicare and Medicaid’s Electronic Health Records Incentive Program.

Two objectives of meeting Meaningful Use Stage 1 include:  Computerized order entry system (CPOE) and providing patients a digital copy of their discharge information. These two Meaningful Use Stage 1 objectives have complemented MGH’s breast cancer prevention program. For example, when a person needs a mammogram or other tests at MGH, MGH staff places the order into the EMR’s CPOE system and the test results are then stored within the patient’s EMR. The radiologist can read the mammogram from the EMR. In addition, if follow up care occurs outside of MGH, the patient digitally receives her test results on a USB drive, email, or CD-ROM. In providing a digital copy of the patient’s test results, the patient’s next provider will have accurate and high quality information for treating the patient.  

Continuing to Improve Outreach and Care Coordination 

MGH’s Breast Cancer Prevention program is in now in its third year and continues to improve their program.

• Increase rate of patients returning for annual mammograms: It is import for patients to return each year for an annual mammogram checkups. Initially, MGH’s program started slow because there was a delay in the installation of their digital mammography machine. That bump in the road resulted in a low rate of free mammograms, as well as a 15% retention rate between Year 1 to Year 2.  MGH is aggressively looking to increase the amount of both patients receiving free mammograms and their retention rate in Year 3.

• Continue to expand on community partnerships for education: MGH continues to successfully partner with local faith-based community organizations for hosting breast cancer prevention seminars and educating underserved patients.

• Electronically exchanging patient information: In the future, MGH plans to begin electronically exchanging EMR data throughout their local Mississippi hospital network to further help coordinate care and serve their rural patients’ needs.

For more information on Magee General Hospital’s Breast Cancer Prevention Program, please contact Ms. Cindy Watkins, the Grant Administrator at cwatkins@mghosp.org