Harnessing Technology to Improve Mammography Effectiveness
Creators: name: University Of California Office Of The President
Publisher: name: University of California Office of the President
publisherIdentifier: https://ror.org/00dmfq477
publisherIdentifierScheme: ROR
Year: 2024

description: One of the goals of the BCRP is to determine the best approaches to prevent death from breast cancer, and to most effectively spend its resources to accomplish this goal. We believe this must include the broad implementation of high quality mammographic screening throughout the state. The specific purpose of this grant is to investigate the factors required to achieve high cost-effectiveness in mammography screening in California, and then develop a plan to promote the provision of the highest quality screening services for the least possible cost. As health care delivery systems change, we need to develop ways to decrease the cost of delivering services, and to maintain high quality. Regionalization and organization strategies for mammography have the potential to markedly improve the quality, and to markedly decrease the human and economic cost of mammographic screening. The emergence of newer technologies, such as digital mammography and telemammography which integrate advances in computerized medical imaging and telecommunications, will provide an opportunity to improve the efficiency of mammography screening by allowing for regionalization without requiring a major overhaul in our current system of health care delivery. (Regionalization is a system of health services delivery which enables the benefits of the expertise and technologies available in the most advanced medical centers to "flow" down to community hospitals and neighborhood health centers.) Digital mammography has the potential for improvement over traditional mammography by increasing clarity and reducing technical errors, film noise, film processing artifacts, and variability in interpretation of mammograms. Telemammography has the potential to significantly improve the quality of breast care by allowing a greater percentage of patients access to the "expert mammography" available in the best medical centers. 
 
 
 
 
 
 
 
 We propose, in the first year, to undertake a more thorough investigation of the underlying basis for what leads to ‘expert’ interpretation of mammography tests and the degree to which false positive readings can be minimized. Our research will include the evaluation of European systems as well. During the second and third years, we will examine the distribution of patients, providers, and payers for mammographic services in Northern California, re-evaluate the technical developments in digital and telemmamography, and analyze the costs of implementing a shared network for mammographic services. We will then devise a strategic plan to introduce the technology which will include incentives to enable cost sharing to promote the highest quality of services for the least cost within the context of the realities of the health care delivery market place in California in the late 1990’s. Clearly, the delivery of health care is undergoing profound change and we will need innovative strategies to assure quality of care. By combining both a scientific and a market-based analysis of the "business" of providing mammographic services, California will be able to use mammographic screening as an example of how changes in organization can lead to significant improvements in care by decreasing the cost, raising the quality of service, and increasing the number of women served.