Document Type

Conference Proceeding

Publication Date


Publication Title

J Gen Int Med


STATEMENT OF PROBLEM/QUESTION: Is a secure messaging system an effective tool to address barriers of time constraints and patient preference for a female provider in order to improve cervical cancer screening (CCS)? In the past 40 years, CCS has significantly reduced the incidence of cervical cancer in the United States 1. However, the proportion of patients without up-to-date CCS increased from 14.4% in 2005 to 23.0% in 20192. One barrier we identified to CCS is patient preference for a female provider to complete their pap smear.

DESCRIPTION OF PROGRAM/INTERVENTION: Our clinic has approximately 20 senior staff physicians and 118 residents. We have an underserved population of patients who are all insured. We use a team-based care model where our medical assistants will prepare patients who are overdue for a CCS at the beginning of the office visit if they are willing to complete their pap smear. We piloted a HIPAA-compliant secure messaging group chat with 10 of our female primary care attending physicians. This group chat is available for any provider or support staff to use when a patient is due for a pap smear, and is willing to obtain it at their visit. This includes scenarios when a patient of a male physician prefers a female provider, or time constraints prevent a provider from doing the pap smear. When a message is sent, all 10 female providers will receive it, and if someone is available to help, they will respond to the group message. If no one is available, no response will be sent.

MEASURES OF SUCCESS: A positive outcome is defined as a message sent accompanied by a response; a negative outcome is a message sent with no response. Quantitative metrics to evaluate this tool include measuring the time elapsed between provider request and provider response, and number of responses.

FINDINGS TO DATE: We piloted this project in 2021. Of 21 provider requests in 1 year, there was an 86% response rate. Average time to response was 2.3 minutes with median time 1 minute. Average number of responding physicians was 1.

KEY LESSONS FOR DISSEMINATION: This intervention conveniently meets patients at the point-of- care clinic setting to improve CCS by addressing barriers, which include time constraints, and patient preference for a female provider. In addition, we have broadened this tool to include interested residents in order to allow them the opportunity to gain procedural experience. This custom yet cost-effective tool can be used for similar preventative health screenings and other sensitive procedures/exams.



First Page