Evaluation of Technology-Enabled Interventions To Increase Cervical Screening Participation Among Underserved Populations

System Requirements

To visually outline how our proposed tools aim to bridge gaps in existing systems and transform interdisciplinary communication, two use case diagrams were developed – illustrating the current vs ideal future state workflows.

As shown in Figure 1 below, the current process is disjointed, relying on manual phone/paper-based communication channels that introduce critical delays:

Future State Diagram

Our newly integrated digital systems would enable seamless data exchange and hand-offs between staff and institutions involved (Figure 2):

Therefore, to realise this future vision, our EHR vendor EMIS will need to incorporate several changes – detailed in the class diagram in Figure 3 below:

By working with EMIS to build custom protocols for our cervical screening registers that can ingest HL7 lab results, automatically flag abnormal findings, instantly notify staff via API alerts, and enable structured data capture for digital referrals and care plans, we can drive significant improvements.

Proposed System Design

The high-level system design, therefore, involves augmenting the use of the existing EMIS platform to remove paper-based processes. Machine-readable structured pathology result data will act as a trigger to automatically kick off downstream workflows to relevant stakeholders through digital alerts, task assignments, and referral initiation. The updated screening pathway powered by the enhanced system architecture is shown in the diagram below (Figure 4):

Through embedded protocols customised by our EMIS implementation team, the EHR will now fully replace manual registries, paper correspondence, and basic email/phone communication channels. Automatic notifications will facilitate rapid case triage to determine whether active follow-up is required or results can be filed if returned to normal. Configurable rules will instantly task-relevant general practitioners or nurses based on urgency as soon as abnormal results are validated. Referral templates will harness digitised data from across the patient record to limit rework. Harnessing the newest FHIR interoperability standards, these referrals will be transmitted electronically directly into the outpatient management systems used at our region’s colposcopy clinics – with acknowledgement messages confirming receipt.

Structured care plans from the specialist visits will similarly return to the central EMIS record – closing the loop to support continuity of care and vigilance in screening histories by all providers involved in a woman’s cervical health journey. By linking the relevant clinical and administrative stakeholders through shared data repositories on the back end, we can realise a fully integrated pathway.

Implementation Plan

In order to systematically deploy the range of infrastructure and software enhancements proposed, a structured implementation roadmap will need to be planned in collaboration with our EMIS implementation partners, the high-level timeline in Figure 5 summarises the phases and milestones expected:

The initial focus during the Build stage will be on working alongside EMIS technical staff to establish the housekeeping elements needed within our system configuration to enable the additional functionality proposed. This includes defining protocols for ingesting the HL7 pathology result feeds, mapping terminologies, configuring user roles/permissions for various alert recipient groups, and building templates for digital referral forms and care plans. Wit