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Program aims to elevate Utah from the bottom five U.S. states for percentage of women being screened for breast cancer
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Dr. Brett Parkinson and the team at Intermountain Healthcare are on a mission. “Utah ranks as one of the lowest in the nation when it comes to women getting mammograms, and we want to change that.”
To make that change, Intermountain Healthcare provides mobile mammography across Utah, generating awareness and delivering critical testing where it is needed. And to help their remote patients get fast test results, they consulted with Verizon for mobile connectivity.
Intermountain Healthcare switched to Verizon’s LTE Business Internet, which provides a fast reliable connection that can go nearly anywhere their mission takes them.
“Our Mobile Mammography serves a lot of women, and it goes to places that don’t have accessible mammography,” Dr. Parkinson said. “So, it alleviates the need for long-distance travel for some women, which could require them to take a whole day off of work. But when a mobile unit shows up at your worksite, or is stationed at a clinic where you’re already seeing your family doc, then it doesn’t have to impact the entire day.”
To provide convenient access to screening, Intermountain Healthcare’s two state of the art mobile mammogram vehicles visit health care clinics, business offices, schools, supermarkets, military bases and tribal reservations.
“Inside the vehicles it feels just like a clinic, and a lot of people are impressed when they come in,” said Sonya Dexter, Mobile Mammography Imaging Coordinator, Intermountain Healthcare. “They’re like, ‘Oh, this isn’t like a trailer at all. It’s like a doctor’s office.’ You walk in and you’re greeted at the front desk just like you would be at a clinic. We have changing rooms that are private, the exam room, and people that care deeply about this purpose. A test takes about 15 minutes, and the program helps up to 20 patients per day.”
As a radiologist with a sub-specialty in breast imaging, Dr. Parkinson knows that convenient access to screening and early detection are crucial to surviving breast cancer. “If we catch breast cancers early, and they’re small and haven’t metastasized, the cure rate can approach 100 percent. We should all strive for 100 percent, bringing the mortality rate down to zero.”
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Our Mobile Mammography serves a lot of women, and it goes to places that don’t have accessible mammography. It alleviates the need for long-distance travel for some women, which could require them to take a whole day off of work.”Brett T. Parkinson, MD, Intermountain Healthcare
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Challenges
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While designing the program, Intermountain Healthcare recognized keys to success would be the vehicles’ ability to remotely transfer screening images back to the hospitals, and to remotely access the hospital’s electronic health network. However, when the vehicles launched in 2019, mobile connectivity was not yet solved. The staff quickly identified several challenges caused by the vehicles’ lack of mobile connectivity:
- Speed of test results: If a vehicle was to conduct testing at a remote site for consecutive days, they would not be able to deliver images for doctor review until the vehicles returned back to the hospital to dock for uploading the images. This would result in delayed image deliveries to doctors, and Dexter knew that wasn’t an option.
“When I first started, it was maybe three days to a week when the images were actually sent to the Intermountain Medical Center radiologists to read,” she said. “Sometimes the images would get dropped and we’d have to resend them. I would constantly have to be on the lookout making sure that all of the images were there for the radiologist. We also had people on the receiving end also looking, just trying to make sure we were getting women taken care of in the best way possible. But it was kind of hit-or-miss for a while.” - Travel: Vehicles initially made roundtrips daily to provide patient images to the hospital. “To ensure daily image transfers, the vehicles initially returned each night to upload images to the hospital staff,” said Erwin Lozano, Telecom Cellular Analyst, Intermountain Healthcare. “Moving the trucks regularly proved costly, as much as $1,400 per day in fuel and manpower.
- Staff: Moving the trucks required a dedicated driver for each end of the route—a driver to move it each day to a testing site, and another to move it back to the docking station for data uploading at night.
- Patient insights: Clinicians desired fast access to their electronic health network to understand patient history.
To help reduce travel expenses and quicken data transfers, Intermountain Healthcare began installing docking stations at several remote locations, designed for vehicle charging and transferring images to hospitals. Intermountain was building up its infrastructure, but also found limitations along the way.
While each of the six docking stations began to improve travel expenses, they were costly - roughly $10,000 for each site. And the vehicles would need to plug into those limited locations for transferring images back to the hospital.
As the vehicles began using the docking stations, Lozano identified another challenge: Data transfers for digital mammography are unlike any other imaging modality, as they can generate huge files, roughly 40 to even 50 megabytes. And those files were being uploaded to three different hospital’s servers. “It turned out they were churning out between 300 and 500 gigabytes a month, and that can be costly,” Lozano said.
- Speed of test results: If a vehicle was to conduct testing at a remote site for consecutive days, they would not be able to deliver images for doctor review until the vehicles returned back to the hospital to dock for uploading the images. This would result in delayed image deliveries to doctors, and Dexter knew that wasn’t an option.
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To ensure daily image transfers, the vehicles initially returned each night to upload images to the hospital staff. Moving the trucks regularly proved costly, as much as $1,400 per day in fuel and manpower.”
Erwin Lozano, Telecom Cellular Analyst, Intermountain Healthcare
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Strategic consultations led to tailored solutions
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With ongoing consulting with Verizon, Lozano quickly deployed mobile connectivity to the two Mobile Mammography vehicles, and ultimately moved to LTE Business Internet following the product’s launch. And to reduce data being sent from vehicles to the multiple locations, Lozano consolidated the three data centers to one centralized location.
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Results
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The move to Verizon’s LTE Business Internet solution ultimately helped Lozano save money for his organization and streamline operations.
With mobile connectivity, sending patient images from remote locations was simplified and expedited. Without needing to be tethered to docking stations for connectivity, technicians could now send images from virtually anywhere in the state, at any time they wanted. This meant Dexter was able to upload images to hospital systems quickly. It also meant that doctors like Parkinson could receive images faster, helping to provide faster results to patients than when the program launched.
Mobile internet connectivity also helped the program save on transportation costs. Now, instead of moving the trucks during the evening to a docking station or hospital, those files are delivered directly from the field, via a single, onboard wireless router.
“Everything started working right away,” Dexter said. “It was absolutely seamless. Things improved dramatically. Even from the more remote places in the state, the Mobile Mammography vehicle had the coverage and uploading ability to send images to the hospital in a timely fashion. Virtually anywhere we were, we had coverage with LTE Business Internet and we could concentrate on taking images.”
“Intermountain Healthcare’s Mobile Mammography teams provide critical, and in some instances even life-saving, breast cancer screening services," said David Jensen, Imaging Operations Director, Intermountain Healthcare. "Given the importance of this work, it is vital that our business partners provide highly reliable, customer centric, and cost-effective service and support. Verizon and their engaged local business client support teams have gone above and beyond to meet those needs for us.”
For Dr. Parkinson, the Intermountain Healthcare Mobile Mammography program has hit its stride. “That connectivity was a game-changer,” he said
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Intermountain Healthcare provides life saving services
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Dr. Parkinson has seen how easier access to mammograms has made a big impact, as it did for a patient named Terri, who decided to have a screening on the day a Mobile Mammography vehicle parked outside of her workplace.
“That’s the beauty of Mobile Mammography,” he said. “She hadn’t had a mammogram for four years, but she saw the Mobile Mammography unit and signed up. And it’s a good thing she did because the mammogram helped her catch it early, which helped save her life.”
When she decided to have her mammogram screening, Terri said she had no reason to suspect anything was wrong, but the convenience of having the screening done right there at her work prompted her to make an appointment.
“I was in the office that day, and I was like, ‘Oh my gosh, I should just go do this. It’s just 15 minutes of my time. I should go check,” she said.
In the days following the screening, she received a phone call requesting she visit a clinic to be retested. The follow-up screening led to a biopsy that showed she had an early-stage cancer that can progress to more invasive breast cancer if left untreated.
“It was pretty terrifying,” she said. “I didn’t see it coming.”
Terri underwent surgery to remove any abnormal tissue in the breast and soon began a four-week regimen of radiation treatment designed to decrease the chances of the cancer returning.
“Every oncologist, every specialist, says catching it early is what we want,” Terri said. “It’s not a perfect outlook. I’m not guaranteed anything. But it’s definitely better.”
Now she’s encouraging others to schedule their mammogram screenings, and she said the Intermountain Healthcare Mobile Mammography program is an effective way to do it.
“It takes away all the reasons not to do it,” she said. “Having it right there, and being able to just walk out of work, do it on a break, go back to work, it just takes all the excuses away. Of setting up an appointment. Of having to drive there. Of having to skip work. Of having to rearrange your life, get a sitter, whatever. It makes it so convenient that you’re like, “Yeah, I’m just going to do it.”
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Things improved dramatically. Virtually anywhere we were, we had coverage with LTE Business Internet and we could concentrate on taking images.”
Sonya Dexter, Mobile Mammography Imaging Coordinator, Intermountain Healthcare
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Important work that hits close to home
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Lozano recounted when he was reminded of the importance of the work of the Intermountain Healthcare Mobile Mammography program.
“One of my neighbors told us she had gotten diagnosed with a lump,” Lozano said. “She told us, ‘I went to the Intermountain Healthcare mobile mammo unit. I like it because it’s private, it’s close to home and they diagnosed me with the growth.’ This was pretty significant because she said her mother had breast cancer.”
His neighbor told him that the growth was tested and turned out to be benign. But he could sense the relief she experienced thanks to the work done by the Mobile Mammography unit.
“It was really rewarding to know that I’m involved with this vehicle—making sure things are running right and making sure the doctors can upload the scans and analyze them quickly and basically get patients diagnosed to let them know if there’s something they need to do about it.”
Finding out this happened with one of his friends, Lozano felt a sense of pride knowing the work he’s doing is making a difference.
“We had never really talked about it until then,” he said. “To have her share that life experience with us made me pretty happy to be involved in this special Intermountain Healthcare project, and our shared goal.”
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Given the importance of this work, it is vital that our business partners provide highly reliable, customer centric, and cost-effective service and support. Verizon and their engaged local business client support teams have gone above and beyond to meet those needs for us.”
David Jensen, Imaging Operations Director, Intermountain Healthcare
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LTE Business Internet is available within the U.S. on Verizon's 4G LTE network. Compatible LTE-enabled router required (Verizon-provided or Customer-provided). Terms apply.