by Candi Helseth
Learn more about the Mobile Women’s Health Unit in RHIhub’s Rural Health Models & Innovations.
While mortality rates among Caucasian and African American women were declining in the last decade, mortality rates were increasing among American Indian women living on reservations in the Midwest. The Indian Health Service (IHS) at Aberdeen, S.D., is working to reverse this trend by providing a Mobile Women’s Health Unit, which travels to remote areas on American Indian reservations in South Dakota, North Dakota, Nebraska and Iowa.
“Breast cancer was being caught late in the disease process and had metastasized to other organs so women (there) were dying at a higher rate,” said Willeen Druley, Women’s Health Consultant at IHS. “We knew we needed to get them earlier detection.”
Since beginning the mobile service in March 2006, about 2,200 women have been screened. The mobile unit regularly travels to 19 reservation locations in the four-state area, providing mammography services at no charge; the unit also provides Pap smears and bone density tests. Druley said mammography services aren’t available in these areas and lack of transportation or other socioeconomic factors prevent these women from traveling to cities where mammography is offered. Reservation health centers’ limited funding rules out installation of mammography technology.
“The clinics and service units in these areas do work very closely with us,” Druley commented. “They advertise the mammography on radio and through posters. And the women’s appointments are scheduled through the service unit.”
The mobile units are equipped to transmit digital mammography images through a commercial satellite service. IHS works with the University of Michigan Health System’s Division of Breast Imaging, which was awarded the bid for providing radiologic assessment of the digital images. With digital technology, an electronic X-ray detector converts the breast image into a digital picture that can be more quickly transmitted via satellite. The University’s radiologists interpret and report their findings within 30 to 50 minutes of the mammogram results being delivered to them, allowing patients who require follow-up to be scheduled for a second mammogram or related follow-up while the mobile unit is still in their area.
Druley participated in a research study of the project that confirmed digital mammograms could be transmitted rapidly by satellite without loss of image quality, even though the images are very large. The study also indicated that patients were very satisfied with the care they received, Druley said.
While statistics are not yet available on whether or not the incidence of breast cancer mortality is declining in these areas, mammography results in 2007 were comparable to the general population, with about .4 percent of the women having abnormal mammograms.
“We are doing screenings only,” Druley stressed. “We’re not doing diagnostic work with the mobile units. The screenings are for women (over 40) who haven’t presented with any problems or who are 40 and need baseline screenings. If a woman has an obvious breast lump, she is sent out.”
Women with abnormal mammography results are referred back to their local service units or tribal health facilities for follow-up. Women diagnosed with breast cancer receive necessary surgery and oncology treatments, regardless of their ability to pay. The continuum of care ensures that women who are diagnosed earlier by mobile mammography receive appropriate treatment while the cancer is still in the early stages.
For more information, contact Willeen Druley at Indian Health Service, (605) 226-7387.
Back to: Fall 2008 Issue