How to Maintain Your Program's Commitment to Breast Health

Nov 8, 2019


For years, the Marin General Hospital Breast Health Center had a successful high-risk breast cancer program, but decided to elevate their program by incorporating risk assessment software. By implementing a digital high-risk assessment tool, High-Risk Nurse Practitioner Maria Dalmacio improved the center's quality, efficiency, and revenues.

Three Opportunities within Marin General's High-Risk Breast Program

Building a valuable cancer risk assessment and genetics program at your facility provides a unique set of opportunities based on any number of factors including systems, staff, and administrative support. Marin General Hospital took advantage of these opportunities allowing them to identify the right patients, increase productivity, and provide financial justification for the program. Here's a glimpse of what Marin General Hospital's Breast Health Center was doing prior to implementing software.

Identifying the Right High-Risk Patients

Marin General Hospital was the first hospital in the Bay Area to introduce high-risk screening through their mammography center.

Despite getting the necessary buy-in from the staff—from the front desk to the doctors and techs—regarding the importance of genetic testing and counseling, Dalmacio discovered their ability to consistently identify high-risk patients was inhibited by a number of factors:

  • Unfamiliarity among tech staff about genetic risk identifiers
  • No standardized questionnaire
  • Use of the Tyrer-Cuzick model was leading to over-estimating patient risk or completely overlooking others who were eligible for genetic counseling
  • Difficulty staying up to date on National Comprehensive Cancer Network (NCCN) guidelines

With the introduction of genetics software, however, and continued staff participation and support, the program began to see a shift in risk identification.

Patients checking in for their mammogram appointments would fill out the CancerIQ intake form on a tablet. That information would then be printed and passed on to the techs, providing risk assessment before the patient appointment even began.

After the mammogram was complete, any at-risk patients would be given the option to set up a genetic counseling appointment to further discuss cancer risks, genetic testing, and preventive care.

Using this new system, the program was able to increase their identification of at-risk and high-risk patients by nearly 4x.

The Breast Health Center at Marin General Hospital sees approximately 11,000 patients each year. Since implementing new tools and standardized system of evaluation, Dalmacio can now determine that 32 percent of those patients are considered at risk. While not every patient is interested in pursuing genetic counseling and genetic testing, of those who are, 88 percent schedule an appointment to receive further care.

Improving the Productivity of the High-Risk Nurse Practitioner


Once Marin General Hospital discovered a consistent and effective way to identify at-risk patients, Dalmacio needed to find a way to manage the increased patient load.

One of her biggest obstacles—a common struggle in the world of productivity versus quality care—was finding a way to reduce appointment and administration time while still having engaging and meaningful interactions with the patients.

For Dalmacio, the solution came in the form of a digital automation and patient portal. Instead of spending 10-15 minutes of new patient appointments drawing up a pedigree, patients could take the at-home self assessment and gather pedigree information prior to their appointment.

Dalmacio further increased appointment and admin efficiency by using smart, pre-populated test order forms, referrals, and documentation. Instead of digging through patient files, every piece of information needed for a specific patient was either digitally prepped or filed for easy access.

Previously, the high-risk nurse practitioner would dictate her notes from patient appointments. She would then send those off to have them transcribed. After two days, she would receive the transcription, correct the notes, and only then would the information get uploaded to the hospital's system. Instead, the CancerIQ software automates documentation notes, allowing Dalmacio to edit and upload her notes to the electronic health record (EHR) with little to no delay.

Overall, Dalmacio reduced her patient intake and appointment time from 1.5 hours to 50 minutes, increasing her efficiency and her ability to see more patients. Not only has the software saved her time and helped her scale the genetic program, they have allowed her to be more focused on each individual patient's journey.


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Proving the Financial Value of the High-Risk Program

Return on investment (ROI) is an important factor when determining the value of a healthcare program. Can genetic testing lead to downstream revenue? What percentage of patients does it benefit? How does the program support other services offered by the hospital or facility?

With a manual or paper-based program, it is difficult to track time, spend, revenue, and patient impact, therefore making it difficult to determine the overall value of the program.

Dalmacio saw this issue reflected in several areas: the amount of time it took to compile patient education material, the inability to efficiently log and track care plan recommendations, and the struggle to identify appropriate patients for the program.

Proving the value of the Marin General Hospital risk assessment program was no longer an issue when the right tools were in place. With CancerIQ, Dalmacio was able to demonstrate a number of core program improvements, not least of which was increased patient capacity.

  • Up-to-date NCCN criteria
  • Accurate identification of at-risk patients
  • Streamlined workflow leading to increased productivity
  • Improved patient engagement and management providing a higher patient satisfaction
  • Proactive patient outreach improving patient referrals and impacting down flow revenue
  • Innovative data and real-time analytics providing comprehensive ROI

From the beginning, the program at Marin General Hospital was an important part of the mammography center. Yet, the implementation of systematic screening and the additional reporting benefits derived from digital tools meant the hospital was able to gain tangible evidence of the program's value and impact.

Building a Sustainable Program

Without solutions to help identify appropriate patients, scale their program, and prove its impact, many providers struggle to see significant increase in their cancer risk assessment and genetics programs. By finding the right tools to help them build, the team at Marin General Hospital were able to increase their service by 4x their previous capacity. That was just the beginning of the value that was added to their risk assessment program.

Reducing appointment time, increasing appointment quality, and improving both patient and staff satisfaction were all a byproduct of finding and implementing the right specialty software. The program also saw how accurate screening improved downstream service utilization and their ability to help patients get the correct treatment, tests, or preventative services.

Learn More

Want to grow your cancer risk assessment and genetics program service capacity? Download the full webinar with Maria Dalmacio to learn more.

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Topics: High-Risk Patients| Breast Centers