# Implementing USPSTF Recommendations for Breast Cancer Screening and Prevention by Integrating Clinical Decision Support Tools with the Electronic Health Record

> **NIH AHRQ R01** · OREGON HEALTH & SCIENCE UNIVERSITY · 2022 · $377,434

## Abstract

Project Summary/Abstract
 Clinical recommendations for breast cancer screening and prevention are contingent on breast cancer risk,
yet methods to accurately determine risk for the 63 million women eligible for services are not widely used in
practice. MammoScreen, a web-based application of a clinical decision support tool, was designed for women
ages 40–74 years to identify their individual risks for breast cancer, engage patients in shared decision making,
guide referrals, and consider screening decisions. Patients receive tailored information based on their risk
profiles and preferences in accordance with USPSTF recommendations. The goal of this digitial healthcare
research project is to improve access and quality of care for women, an AHRQ priority population.
 Although numerous breast cancer risk assessment tools are publically available, none exchange data with
the patient’s electronic health record (EHR), missing important opportunities to fully integrate patient
information into prevention decision-making at point of care. MammoScreen was developed and previously
tested by the interdisciplinary team of investigators for the proposed project. In a pilot study, data from
MammoScreen required manual entry into the EHR, which is not feasible across large health systems.
 The proposed project makes innovative use of the SMART (Substitutable Medical Applications, Resuable
Technologies) on FHIR (Fast Healthcare Interoperability Resources) standard to exchange data to and from
applications external to the EHR, such as MammoScreen, to fully integrate them into routine healthcare. The
use of the SMART on FHIR standard will allow this approach to be scaled not only to a single health system,
but to any EHR system that supports the SMART on FHIR standard.
 The objectives of this project are to demonstrate the ability of the EHR to securely exchange information
with MammoScreen using interoperable, standards-based approaches; provide appropriate clinical and patient
decision support for users; and evaluate its use among patients and clinicians using mixed methods based on
the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation and Maintenance). Accomplishing
these goals would lay the groundwork for integration with other types of healthcare-related applications
designed to extend decision support outside the clinical setting.
Aim 1 (Years 1 & 2): Implement standards-based, safe, secure, interoperable integration of
MammoScreen with the EHR.
Aim 2 (Year 1 & 2 and again, Years 3 & 4) Evaluate MammoScreen acceptance by patients and
clinicians to identify and remove potential barriers to use.
Aim 3 (Years 3-5): Evaluate use of EHR-integrated MammoScreen by clinicians and patients across age
groups (40–49 years; 50–74 years) and measure clinical outcomes.

## Key facts

- **NIH application ID:** 10470144
- **Project number:** 5R01HS027796-03
- **Recipient organization:** OREGON HEALTH & SCIENCE UNIVERSITY
- **Principal Investigator:** Karen Beekman Eden
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2022
- **Award amount:** $377,434
- **Award type:** 5
- **Project period:** 2020-09-30 → 2025-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10470144

## Citation

> US National Institutes of Health, RePORTER application 10470144, Implementing USPSTF Recommendations for Breast Cancer Screening and Prevention by Integrating Clinical Decision Support Tools with the Electronic Health Record (5R01HS027796-03). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10470144. Licensed CC0.

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