The failure of large numbers of patients to show up
for exams in a timely fashion, or be treated in a timely fashion, or to be
treated at all, results in an enormous burden of death and disease. The
Health Communication Technology Group uses modern computer speech,
telephony, and web-programming to build systems that can help recruit,
remind, schedule, and track patients.
- Our studies have found that while most women begin mammographic
screening close to their 40th birthdays, as recommended, one-in-four
women never return for an additional screening mammogram.
- Among the women who do return, screening intervals of 2, 3, 4 and
more years are common.
- One-quarter of women who make appointments for screening mammograms
forget to attend them.
- Our computer simulation studies have indicated that this
underutilization of screening probably increases the breast cancer death
rate by 50%.
Much of the failure to use screening to its fullest can
be ascribed to the absence of effective reminder tools:
- While the staff of many screening centers make heroic efforts to
call women to remind them of their upcoming appointments, such efforts
are both costly and inefficient
- Screening centers usually make their reminder calls during the day
when they are open, but most women are usually away from home at that
- Few screening centers have individuals who speak Spanish, Chinese,
and other languages in widespread use.
- Systems for identifying women who have not made appointments for
screening mammograms do not exist.
- Nor are there tools for notifying women who have missed
appointments, so that they can be rescheduled.
To solve these problems, we have developed an
integrated breast cancer tracking/reminder system, which sends computer
generated telephone reminder messages to women to make, and then keep,
appointments for screening mammograms. We are now funded by the Komen
Foundation to provide these reminder messages to the women of Massachusetts,
and thus test the impact of this system on utilization of mammographic
screening and on breast cancer survival.
We are also engaged in collaborative project with Dr
Karen Emmons and the Greater Lawrence Health Center to examine the impact of
computer generated reminder messages designed to recruit patients for
The long-term focus of the Health Communication
Technology group is to use modern computer speech, telephony, and
web-programming to build systems to recruit, remind, schedule, and track
patients, so as to keep them in good health. Future projects will concern
the development of systems for informing patients of the availability of
influenza vaccine, for recruiting and reminding patients of for colorectal
cancer screening, for tracking patients with signs suggestive of breast
cancer, for reminding patients to take their medications, and for many other
aspects of preventive health.