Leveraging a quality and safety continuous process improvement framework to increase breast cancer screening access.

Missed mammograms in the primary care safety net can increase national breast cancer diagnostic disparities. This study applies continuous process improvement cycles to design and evaluate a digital reminder program’s impact on Screening Mammography Missed Care Opportunity (SM-MCO) rates at federally qualified health centers and mammography van using a combination of texts, standard reminders, and videos. Paradoxically, no-show rates were higher with text reminders and fell with digital engagement, highlighting a digital divide. The results illustrate that quality improvement frameworks can help monitor and refine digital strategies to expand radiology access.