How Cone Health maximized the impact of its mobile cancer screening unit

At the Oncology Roundtable’s first-ever Cancer Screening Innovation Showcase, nine organizations presented their innovative strategies to improve cancer screening to 60 oncology professionals. Attendees then voted on which three innovations were the most creative and impactful.

Cone Health's Mobile Cancer Screening Unit was selected as one of the top three screening innovations. Keep reading to learn more about Cone Health's creative approach to increasing access to cancer screening.

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The challenge

Cone Health, a six-hospital health system based in North Carolina, had low cancer screening rates in their service area like many other health systems. For example, data collected in 2019 before the implementation of the Mobile Cancer Screening Unit showed that only 41% to 45% of eligible women in Cone Health's service area received screening mammograms.

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Based on patient feedback, Cone Health's Oncology Outreach Manager identified transportation barriers as the primary cause of their low screening rates. Patients had trouble securing transportation for screening appointments, especially when they were eligible for multiple screenings and had separate appointments for each one.

Cone Health initially tried to address these barriers by implementing a transportation reimbursement program for qualifying patients, but it was unsuccessful in removing them.

The innovation

In a second attempt to address transportation barriers to screening, Cone Health introduced a Mobile Cancer Screening Unit in May 2021, which aims to bring screening services directly to patients' communities and give them the option of receiving multiple screenings during the same visit. This reduces how far and how many times patients must travel to receive recommended screenings, saving them transportation costs and time.

Here's everything you need to know about how Cone Health set up their Mobile Cancer Screening Unit:

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• Facility: The unit consists of a converted bus with two exam rooms and the same cancer screening equipment that would be used at a hospital or clinic.
• Services: To date, the mobile unit has only performed mammograms and PSA blood tests and distributed FIT tests. But Cone Health plans to offer clinical breast exams, Pap smears, oral cancer screening exams, and lung cancer screening eligibility counseling (as well as CDC's WISEWOMAN program to help women understand and reduce their risk for heart disease and stroke) on the mobile unit in the future.
• Staffing: Mobile unit staffing is dependent on which screenings are being offered each time the unit goes out. For mobile mammogram events, the unit is staffed by The Breast Center of Greensboro Imaging, a Cone Health partner, which provides one or two mammogram technicians based on expected patient volume, one administrative staff member to register patients, and one driver. For all other screenings the mobile unit is staffed by Cone Health's Oncology Outreach Department, which provides at least one nurse, one or two phlebotomists to draw blood based on expected volume, and one or two administrative staff members to register patients based on expected volume.
• Location: The mobile unit provides screening services in various locations throughout the community with input from community partners (e.g., local physician practices, businesses, and churches) on location, marketing, and identification of unique screening needs of specific populations. The unit is also regularly stationed on-site in the parking lot of one of Cone Health's primary care clinics to increase patient compliance with recommended screenings by allowing them to get recommended cancer screenings all at once immediately after their primary care appointment.
• Funding: Screenings are usually fully covered by health plans for insured patients, but financial aid programs are available for uninsured patients who can't afford screening. These programs are funded by Cone Health (Mammography Scholarship Fund), federal and state grants (Breast and Cervical Cancer Control Program and WISEWOMAN), non-profit organizations (ZERO Prostate Cancer Run/Walk), and local community member donations.

The impact

Cone Health has already been able to provide access to screening for a significant number of patients in its community since launching the Mobile Cancer Screening Unit. The mobile unit provided 1,108 screening mammograms from May through December 2021, of which 558 were for uninsured women who received support from one of Cone Health's screening financial aid programs. Additionally, the mobile unit distributed 70 FIT tests for colorectal cancer screening and performed 25 prostate cancer screenings (three of which were PSA tests).

The Mobile Cancer Screening Unit has provided screening in more than 45 locations in their service area, including some of the rural counties that are farthest away from Cone Health's brick-and-mortar facilities. Cone Health decided to take the mobile unit to one of these rural counties after clinicians referred 60 patients living in that county to the mobile unit.

The takeaway

The early success of Cone Health's Mobile Cancer Screening Unit adds to the evidence that mobile screening can be an effective strategy to increase access to cancer screening, particularly among patient populations facing transportation barriers. Additionally, Cone Health’s decision to offer multiple types of cancer screening on its mobile unit provides a unique example of how health systems can maximize the impact of a mobile cancer screening unit on screening rates in the community.