Over half of Americans fail to receive health screening tests that could potentially save their lives, and the percentage is much higher among underserved populations.
The founders of mPATH® set out to test a theory: Would more patients choose to have screenings if it were as simple and convenient as booking an airplane flight online?
Clinical studies found that the answer was a resounding yes. mPATH’s cloud-based solution allows patients to learn about and elect to receive screenings – all thanks to a prompt from a text message.
With 85% of adults owning a smart phone, this method has proven highly effective. Compared to traditional outreach methods, the mPATH system more than doubled the percentage of patients who signed up for screenings and followed through with receiving them.
In June 2024, mPATH was one of 5 entrepreneurial companies named winners of the 2nd Annual Health Equity Innovation Challenge (HEIC). The Challenge, sponsored by Atrium Health- Greater Charlotte North Area and administered by the Flywheel Foundation, targets early-stage businesses focused on addressing healthcare inequities.
“That is exactly at the heart of why we started mPATH and why we do what we do,” said co-founder Dr. David Miller. “Our research team at the Wake Forest University School of Medicine developed mPATH as a way to reach more individuals with literacy, income and other access barriers, to specifically improve health equity. This is a fantastic opportunity to partner with other like-minded individuals.”
The Cumbersome Process of Accessing Screenings
Diagnosing cancer in its earliest stages – or preventing it from ever occurring in the first place – results in far better outcomes and lower treatment costs. It also helps healthcare systems improve their performance on preventive care quality metrics.
But the current methods of persuading patients to get screenings are reaching too few people. Often, patients only learn about screening tests when their physician thinks to suggest them during an in-person visit. Another method — designating a full-time employee to make phone calls to patients about screenings — is cost-prohibitive for most medical practices, and many patients simply screen out their calls because they don’t recognize the phone number or the call comes at an inconvenient time.
By contrast, mPATH’s text messaging system is particularly effective at reaching patients and giving them the option to respond when they are ready. The messages are branded with the name of the patient’s physician’s office, giving them instant credibility.
Getting appropriate health screenings can make the difference between life and death. “Lung cancer, the number one cause of cancer death in the United States, also has a highly effective screening test,” Miller said. “But 90% of high-risk individuals in the United States are not getting screened for lung cancer. Part of it is that people don’t know the test even exists, or they may have seen a billboard but don’t think it applies to them, or they think that if the screening finds evidence of lung cancer, it’s automatically a death sentence, when in fact if lung cancer is caught at an early stage, it can be treated very effectively.”
With colon cancer, the second most common cause of cancer deaths, screening identifies pre-cancerous polyps that can easily be removed and prevent cancer from ever occurring. Yet some patients may be afraid of the test or think it will be difficult or embarrassing, Miller said.
Simple Process Begins With Text Message
The mPATH process begins when the patient receives an automated text message, letting them know about a screening test that they might qualify for and inviting them to click a hyperlink to learn more. To make the material clear even for those with limited literacy skills, it is written at the sixth-grade reading level.
“Once they click, the program immediately starts on their device,” Miller said. “It asks questions and uses algorithms to determine, first, do they need the screening and second, if they do, do they have risk factors that would change the screening recommendations we would give.” This is particularly important with colorectal cancer screening recommendations, which can vary depending on a wide variety of factors such as having a close family member with cancer or personal history of polyps.
“We give patients personalized recommendations for them, and we show them a short video that we produced, which is based on principles of behavior change, to educate them, but also motivate them to get screened. Our videos include short testimonials from people who have been screened, talking about why they chose to be screened, what the screening process was like, and why they think it’s important. And then the program ends by letting patients request a screening test directly through the program, without ever stepping foot in their doctor’s office.” The patient then receives a call from medical staff to actually schedule the screening.
mPath’s technology has made significant differences in screening rates for both lung and colon cancer. In a large randomized controlled trial funded by the National Cancer Institute, mPATH doubled the number of patients who completed screening for colorectal cancer. Patients in this study faced significant barriers to care: one-third had limited literacy and half had annual incomes below $20,000. Despite these barriers, mPATH was able to double the number who were screened and found over twice as many patients with pre-cancerous polyps.
Results were similar with lung cancer, Miller said. “We sent a patient portal outreach message to 1,000 randomly selected patients who may be overdue for lung cancer screening. Over 400 patients visited mPATH in response, and 86% of all visitors completed the program.”
Cassie Allen, head of commercial development for mPATH, said the system is successful because it empowers the patient to make their own choices. “People are more likely to follow through when they feel they have made a choice based on information that makes them feel comfortable. We approach people with respect. We meet them where they are, and we give them good information that is concise and clear.”
mPATH Proves Superior at Identifying Patients to be Contacted
Before patients are ever contacted about the availability of a test, though, they first have to be identified as being eligible. Most physician offices currently use their own electronic health records system to identify patients who should be alerted about various types of screenings.
Again, the mPATH system proved superior in identifying the patients who needed to be informed. “We give the provider a very simple query they can run on their electronic health records system to identify patients at risk, who have no record of recent screening, and we can program it to screen by other criteria as well,” Miller said.
In one pilot study, mPATH found over 330 patients who needed lung cancer screening. Of these patients, the electronic health record had only identified 35% of them as needing screening. “Relying on the electronic health record alone would miss two-thirds of people who could benefit from this life-saving test,” Miller said.
mPATH is not intended to replace human staff members, but it does free up existing staff to answer questions about the tests that some patients will have – questions that are more detailed or person-specific than the mPATH program is designed to answer, Miller said.
Expanding mPATH to Other Health Care Areas
So far, more than 70,000 patients have used the mPath system, and the potential uses for the program are endless. A breast cancer module is being launched in the first quarter of 2025, and mPATH is also developing a version of the program, in collaboration with researchers at UNC-Chapel Hill, that is designed specifically to appeal to the American Indian community.
Although it was first developed for cancer screening, mPATH can be programmed to address many other types of illnesses and other needs, such as persuading patients to get vaccinations.
The opportunities to expand geographically are also limitless. Health care systems in other states have shown real interest in the program, Miller said.
Being a HEIC winner opens up the possibility of expanding mPATH utilization within Atrium Health in the greater Charlotte area.
“The mentoring and connections that come from being part of the HEIC program are a wonderful resource,” Miller said. “The experts we have been paired with are incredibly supportive in helping us reach our goals, and being able to collaborate with our fellow cohort members gives us an opportunity to learn from each other and bounce ideas off each other.”
