Well-Women's Health Screening

WHA reports three Healthcare Effectiveness Data and Information Set (HEDIS) preventive health screening measures for women.

• Breast Cancer Screening (BCS) measure assesses women 50-74 years of age who had one mammogram to screen for breast cancer in the past two years. 
• Cervical Cancer Screening (CCS) measure assesses women who were screened for cervical cancer using any of the following criteria:
  • Women 21–64 years of age who had cervical cytology performed within the last 3 years.
  • Women 30–64 years of age who had cervical high-risk human papillomavirus (hrHPV) testing performed within the last 5 years.
  • Women 30–64 years of age who had cervical cytology/high-risk human papillomavirus (hrHPV) co-testing within the last 5 years.
• Chlamydia Screening (CHL) measure assesses the percentage of women 16-24 years of age who were identified as sexually active and who had at least one test for chlamydia during the measurement year.
• Osteoporosis Screening (OSW) measure assess women 65-75 years of age who received osteoporosis screening.

Screening can improve outcomes: Early detection reduces the risk of dying from breast cancer and can lead to a greater range of treatment options and lower health care costs. Effective screening and early detection of cervical pre-cancers have led to a significant reduction in this death rate. Chlamydia is the most commonly reported bacterial sexually transmitted disease in the United States. Untreated chlamydia infections can lead to serious and irreversible complications. 

WHA’s HEDIS Screening Rates:

Potential barriers that contribute to decreased preventive health screenings include; 
Lack of provider recommendation for regular cervical cancer screening. EHR Health Maintenance lists not including alerts prior to due dates.  No process for timely reminders to patients. Standing orders or automatic ordering, such as for chlamydia screening with cervical cytology for females 16-24, may be disrupted. Lack of systems/processes to identify patients who need screening and staff resources for outreach to those patients.  Delayed access for mammograms and/or well-woman exams. Lack of patient education materials in the provider office. Public debate of the guidelines has contributed to patient confusion regarding screening recommendations as to appropriate age and frequency of screenings.

ACS Breast Cancer Screening Guidelines. American Cancer Society. (n.d.). Retrieved September 8, 2022, from  https://www.cancer.org/cancer/breast-cancer/screening-tests-and-early-detection/american-cancer-society-recommendations-for-the-early-detection-of-breast-cancer.html  

Centers for Disease Control and Prevention. (2022, April 12). Detailed Std Facts - Chlamydia. Centers for Disease Control and Prevention. Retrieved September 8, 2022, from https://www.cdc.gov/std/chlamydia/STDFact-chlamydia-detailed.htm 

Follow-up after cervical cancer screening: New strategies for an informed approach to patient triage. Medscape. (2021, January 11). Retrieved September 8, 2022, from https://www.medscape.org/viewarticle/943378 

Laurie Barclay, M. D. (2020, July 25). ACOG updates routine well-woman annual screening guidelines. Medscape. Retrieved September 8, 2022, from https://www.medscape.com/viewarticle/739356 

Walsh, T. (2022, July 14). Report outlines how to overcome barriers to osteoporosis care. NCQA. Retrieved September 8, 2022, from https://www.ncqa.org/news/report-outlines-how-to-overcome-barriers-to-osteoporosis-care/