Only 17% of patients self-schedule mammograms, with preference for nights and weekends

Only about 17% of patients choose to self-schedule mammograms, with a preference for nights and weekends, according to new research published July 12 in JACR [1].

While the number may appear low, interest in this option continues to increase, noted experts with Johns Hopkins Medicine in Baltimore. Corresponding author Emily B. Ambinder, MD, and colleagues believe their data demonstrate that patients are unlikely to self-schedule 100% of mammograms in the near term.

“Our results suggest that patients using the self-scheduling option benefited from appointment slots during evening and weekends. However, our analysis also suggests the need to continue offering staff-scheduled appointments in order to best serve those requiring a more rapid diagnostic evaluation,” wrote Ambinder, who is assistant division chief in the Russell H. Morgan Department of Radiology and Radiological Science, and co-authors.

For the study, researchers analyzed data from all diagnostic mammograms performed at the academic institution between June 2021 and the end of 2022. Patients who utilize self-scheduling at Johns Hopkins must already have an order for the exam placed by their provider. The health system expedites requests for those who have an abnormal screening exam. Scheduling staff can decide to overbook an appointment slot to accommodate an individual with an urgent problem such as a breast abscess. But self-scheduling patients do not have this same ability to expedite an exam.

A total of 23,150 diagnostic mammograms were included in the analysis, with nearly 83% (or 19,163) scheduled by staff members. Hopkins saw increasing interest during the study period—rising from about 100 self-scheduled exams per month up to over 200 by the conclusion. Among patients who made the appointment themselves, 35% selected slots outside of regular 8-5 business hours. Evening and weekend appointment times were not available via staff scheduling, the authors noted.

There was a total of 33 no-show or canceled appointments during the 18 months. Those included one self-scheduled exam and 32 booked by staff (0.03% vs. 0.17%). Patients presenting for a callback after an abnormal screening mammogram were least likely to self-schedule.

“This is likely due to our institutional policy of calling all recalled patients by phone within two business days to facilitate scheduling,” Ambinder and colleagues wrote, adding that patients presenting with breast-related symptoms also were less likely to self-schedule.

Meanwhile, those presenting for annual surveillance or follow-ups were more likely to use self-scheduling, possibly because of greater awareness. Patients under 50 were nearly four times more likely to use self-scheduling compared to women 70 or older.

Those who self-scheduled also had a “significantly” longer time interval between when they booked the appointment and when the exam took place. This averaged about 46 days between the two occurrences compared to 28 days for those who scheduled with staff.

“The cause of this is likely multifactorial. Patients use self-scheduling for convenience; these same patients may have more limited availability and therefore choose later exam dates that best work with their schedules,” the authors noted. “In addition, our staff can often see cancellations or double-book appointments to expedite appointments for patients who staff-schedule. For most patients at our institution, the difference in wait time between staff scheduling and self-scheduling is unlikely to impact clinical outcomes. However, for patients with urgent/emergent symptoms for a breast abscess, it would be beneficial to have staff call to schedule an appointment.”

Read more at the link below, including potential study limitations.