From education to healthcare, COVID-19 has turned the world upside down and forced people to adapt to new ways of doing things. Reliance on digital communication to work at home, participate in online education, and even see a physician when absolutely necessary, became the “new normal”. Outside of that, many people postponed or cancelled regular health visits and elective outpatient procedures. And because breast cancer screening does not lend itself well to telemedicine, many thousands of women missed their annual screening mammograms.

Now that imaging centers are beginning to reopen for screenings, it is imperative that the patient experience remain a principal focus, and not be overshadowed by the necessary focus on ensuring the safety of patients and staff from COVID-19 infection. Why?  Because cancer can’t wait despite COVID.  In a recent webinar hosted by GE Healthcare, a panel comprised of clinicians and patient advocates came together to share their thoughts and experiences about what patients may be feeling as they begin to return for breast cancer screenings, and why a continued focus on the patient experience is so important, now more than ever.

Encouraging Patients—Getting Back to Breast Screening

The panelists involved in the discussion mutually agreed that communication is most critical to ensuring that women do not skip their annual screening due to fears of getting infected with COVID-19. Annual mammography screening has historically been met with non-compliance on the basis of anxiety, lack of education and access. The COVID-19 crisis has unfortunately added yet another layer of anxiety to the ask, as well as created an additional lack of access for those who may have lost their jobs or health insurance during the pandemic.

Moderating the discussion, GE Healthcare’s Bonnie Cowan, Clinical Marketing Leader for Breast Imaging pointed out that the patient experience for one person looks very different than for another, starting from the patient’s ability to access an annual screening exam, and called on the panelists to speak from their own experiences either as patients, clinicians and/or patient advocates about the importance of the patient experience as women start to come back for breast cancer screenings.

Panelist and CEO of the Brem Foundation, Andrea Wolf, explained that some organizations, like the Brem foundation, already had programs in place to increase access to screenings for women, and now in light of the potential impacts on screening compliance due to the pandemic, the Brem Foundation has also started a breast health COVID emergency initiative to help women return for screenings.

In cooperation with organizations like GE Healthcare, patient advocate organizations are working day and night right now to try to improve access for women who are unable to access tests; helping to fund diagnostic and screening exams for women who otherwise couldn’t afford them, and identifying and assisting those women who might be experiencing challenges with child care, time off work, or transportation.    

Maintaining Patient Comfort in a New Screening Environment

Once patients are in the office, their experience is even more critical. Heather Chait, MD, Director of Clinical Program Management and Data Strategy at GE Healthcare, discussed the importance of the screening environment and its affect on the patient experience. As a patient herself, she spoke to the important work from the GE team, focused on embracing the patient perspective and encouraging women to come back during this difficult time.

Screening providers have made many changes to create an inviting space for women to experience a screening mammogram, with warm and personable staff who genuinely care about the patients they see. Dr. Chait feels that COVID-19 is certainly putting a damper on those efforts because of the protocol changes necessary to keep patients and staff safe, but also pointed out the importance of not losing sight of the patient experience.

In today’s environment, Cecilia Olsson, Patient Experience Leader in Breast Imaging and breast cancer survivor stated that in many cases we’re hearing that most waiting rooms have been eliminated and the patients call from their cars to alert staff that they have arrived. Patients prepare for the exam in the exam room, bypassing the changing area completely. Upon reflecting on her own experience, Olsson commented that despite COVID, the reassuring words from the staff have not changed, and still positively affect every woman’s screening experience and healing journey, regardless of the necessary sterile environment. Breast health providers are tirelessly working not only to keep people physically safe, but to make them emotionally comfortable as well.

Communicating Risk and Improving Breast Health Education

In addition to the continued focus on increasing screening compliance by improving access and breast health education for underserved communities, breast health providers also need to focus efforts on reaching out to patients who missed screenings during the months breast imaging centers were closed and creating a strategy around fully serving their patient communities as the number of patients able seen per day has decreased with the new protocols.

Under these new circumstances, the value of women understanding their own breast cancer risk factors such as breast density and genetics has become particularly apparent.  

The panel unanimously agreed that if patients understood their own risk, they would be more likely to return for screenings. , When women know what they need to know about their risk factors and their screening options, they have a lot better sense of what they need, and what’s going to give them peace of mind. From her experience as a patient as well as a clinician, Dr. Chait acknowledged that patients ultimately want to maximize the chances of finding an early, and curable breast cancer.

To illustrate progress to-date that’s been made in breast health education efforts, Wolf explained that in 39 states, there is legislation, called density inform laws, that mandates a mammography report indicate to women that they may have a risk factor for breast cancer and that there are essential screenings they may need beyond a mammogram. The panel stressed the need for a unified effort to reach women so they understand their own risk factors.

The importance of patient experience continues to be a key factor in increasing screening compliance, where many breast cancers are found in the early stages. 

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