Dr Welman on a Study of the Effects of Patient Navigation on Breast Cancer Screening

“We [implemented] a multi-pronged intervention focused on reducing the time to cancer diagnosis and hopefully reducing the incidence of late-stage cancer.”

Martha Welman, MD, chief medical officer at Neighborhood Health, discussed the implementation of a multi-pronged intervention designed to streamline the breast cancer screening and diagnostic pathway for underserved patient populations.

Welman emphasized that many patients served by federally qualified health centers face significant barriers—including limited English proficiency, transportation issues, and low health literacy—that often prevent them from successfully navigating the complexities of breast cancer care on their own. Consequently, the management objectives of this project shifted toward a model of intensive, one-to-one patient navigation to reduce the time from screening to final diagnosis and ultimately decrease the incidence of late-stage cancer, according to Welman.

She noted that a critical component of this strategy involved hiring bilingual patient navigators to work directly with non-English speaking patients, ensuring orders were completed quickly and efficiently. Beyond individual navigation, she highlighted several system-level improvements aimed at removing institutional barriers. These included partnering with mobile mammography units to provide screenings at primary care sites, using bi-directional, secure text messaging to improve communication, and implementing standing orders. These standing orders were vital, she said, as they allowed clinical staff and navigators to schedule necessary follow-up studies without waiting for a physician to manually update an order, effectively bypassing a common administrative bottleneck.

To evaluate the efficacy of these interventions, Welman and colleagues conducted a study that tracked patient outcomes from April 2024 to August 2025. The analysis revealed that these improvements significantly reduced delays across every stage of the diagnostic process. The average time to complete a screening mammogram order decreased by 48%, falling from 79 days in 2023 to 41 days in 2025. Furthermore, the time between an exam recall and follow-up imaging was reduced by 51%, and the time from diagnostic referral to completion dropped by 47%. The data also showed a 48% decrease in the time to biopsy completion, which reached a median of 21 days in 2025, compared with 40 days in 2024.