Getting to a doctor’s appointment when you have a laundry list of things to do can be cumbersome at best. Even when the office is just a few blocks away the task can seem a bit daunting. For women on the go, healthcare is about convenience.
Healthcare providers are listening to their clients more and more these days and are coming up with convenient solutions. One such answer to the question, How will I ever fit this in? is mobile care. Breast Care for Washington has teamed up with RAD-AID and Hologic to provide mobile breast mammography. This month a new, 45-foot van may be rolling into a parking lot near you.
The van is a donation from RAD-AID, a medical technology company based in Chevy Chase, Maryland. Its mission is to “improve and optimize access to medical imaging and radiology in low resource regions of the world.” Liz Davey, Breast Care for Washington’s vice president for development and communications, spoke to EOR magazine about the gift. “This was actually created for another project and then something went wrong with that. We got connected to them through one of our board members. Breast Care for Washington was originally envisioned as a mobile program. When Beth [Beck] and I drove to North Carolina to look at it we were thinking, ‘Yes, we’ve got to take this.’”
With a donation of a 3-D mammography machine from Hologic (the second machine donation from the firm) and some technical assistance with other odds and ends involved in running and maintaining a “mammovan,” Breast Care for Washington is gearing up to be a one-stop shop for women’s breast healthcare.
Location, Location, Location
Breast Care for Washington has been serving women in the District for five years, and growing stronger every day. The fixed site is located inside the Conway Health and Resource Center on Atlantic Street in Southwest. It provides screening and 3-D diagnostic mammograms, follow-up services and patient navigation. Insurance is not required and neither is a referral. Walk-ins are welcomed. According to Breast Care for Washington’s tally, since opening in 2014 it has performed 7,000 mammograms and detected 54 breast cancer cases.
The idea with the mobile unit is similar to the fixed site: having mammography in the same place and time as the primary care physician. Davey says consistency builds trust with the target community. “Our goal is to bring mammography to primary care and do that on a regular schedule. If we know that [for example] Whitman Walker Health is doing primary clinics every third Thursday, we can schedule the van to be there and women will know that it’s going to be at that location. We’re trying to be strategic and figure out how we can make the biggest impact. Why not have it right there when you go into your doctor’s office?”
The patient-navigation piece is arguably the lynchpin of cancer care. A woman may face a result she isn’t ready to hear. A navigator can be a tremendous help in that moment. Research has shownthat navigators can reduce patient disparities. Davey says Breast Care for Washington’s navigation services will be prepared to help women at practically every turn. “Women with this mobile unit will have the same level of navigation services. We do translation services, transportation services, we go with people to appointments if we need to. Because we are small, we are able to do intensive navigation.”
Assessing and Addressing a Need
Breast cancer rates in the District have been stagnant but elevated for more than a decade. According to the DC Department of Health, breast cancer is the most commonly diagnosed form of cancer in the city. While white women may be more likely to be diagnosed with it in the District, black women are more likely to die from it, according to the DC Department of Health’s 2012 statistics.
But there is hopeful news about the women in Wards 7 and 8. According to the 2016 DC Behavioral Risk Factor Surveillance System, the two wards in the most eastern locations in the city have the lowest number of women who had a mammogram in the last two years.
Breast Care for Washington hopes to change that. “It’s hard to get women to get mammograms,” Davey explains. “We’ve found that with our fixed site and probably with this van too, for a lot of reasons. People are afraid. They’re afraid of the process. They’re afraid of what they will find out. We will be doing a lot of education with it as well.”
The mammovan aligns with goal of the District of Columbia Healthy Communities Collaborative to create more place-based care spaces in underserved communities. The collaborative, comprised of four local hospitals, four community health centers and two associations, came together in 2012 to “assess and address community needs in a data-driven, community-engaged manner.” It created a community health improvement plan to address the larger determinants of health such as health literacy and care coordination. Place-based care, bringing care into convenient spaces such as community centers or local schools, was selected by 19 percent of participants in the collaborative’s online survey in 2016 as a way to provide culturally sensitive care.
The next step for Breast Care for Washington is fundraising. Staffing, supplies, vehicle maintenance and insurance all add up to a costly service. Although it receives reimbursements for services, Breast Care for Washington will have to be resourceful. It has received generous donations so far from nonprofits such as the Cafritz Foundation, CareFirst Blue Cross Blue Shield, Qlarant Foundation, McDermott, Will & Emery, The Power of Pink and Comfort One Shoes. But it’s going to take more to keep things running smoothly. Breast Care for Washington’s fundraising goal is $50,000, and to give partners exposure it offers logo placement on the mobile unit.
For more about the mobile mammovan or breast health, call Breast Care of Washington at 202-465-7164 or visit www.breastcaredc.org.
Candace Y.A. Montague is the health reporter for Capital Community News.