“Hello Madam, this is the primary health insurance fund of Dordogne“, recites one of the twelve advisors on the Périgueux call center. She then explains the screening protocol to the insured and suggests, with their agreement, to make an appointment with the radiologist or to order a screening kit for colorectal cancer in pharmacies.
“Upstream, we ask the departmental funds to work with care providers, particularly radiology practices, to reserve appointments within fairly short deadlines.“, explains the director of the CPAM of Dordogne Delphine Camblanne.
Since January, six other call platforms, on which 112 advisors are distributed, have spoken every day with policyholders to encourage them to get tested.
Cervical, breast and colon cancers… The new national system focuses on the three diseases which are the subject of organized screening. France is indeed struggling to achieve the objectives set in Europe. In 2021-2022, the CNAM recorded a 47.7% participation rate for breast cancer, well below the European target (70%).
More than a million calls recorded nationally
From January 1 to May 10, “more than a million calls were made nationallyl”, assures the CNAM. Among them, 235,086 policyholders were able to be supported, with an appointment for just under half of them.
The device responds “the need to reach out to populations far from the healthcare system“, according to Dr Catherine Grenier, director of policyholders at the CNAM.
In the preferred age group for these screenings, the insured persons contacted meet one of these criteria: not having received reimbursed care in the last 24 months, not having a general practitioner and/or benefiting from complementary health insurance united.
Prevention topics that concern more than the rights of policyholders
To convince them, the advisors followed training conducted by the CPAM of Dordogne, chosen by the CNAM to coordinate these call platforms due to its experience acquired since 2008.
“The Dordogne already made its platform available to all funds at the national level in order to carry out campaigns for access to rights and care.“, says Dr. Grenier.
“The novelty is that we are now touching on prevention topicswhereas previously the actions focused more on information campaigns on the rights of policyholders“, she adds.
Fear of results slows down screening
To fulfill this new mission, the CPAM of Dordogne borrowed “motivational interviewing techniques” to that of Tarn, responsible for the Sofia system for monitoring chronic diseases such as diabetes and asthma, explains Delphine Camblanne.
Equipped with scripts “validated by the medical world“, specifies Valérie Valignat, project management manager (MOAD) of the plateaus”move towards prevention“, advisors are equipped with arguments to respond to an insured person’s refusal.
https://www.whatsupdoc-lemag.fr/article/lia-depiste-aussi-bien-les-cancers-du-sein-que-les-radiologues-une-etude-confirmer
“We ask open questions to spark an exchange“, explains Ingrid, advisor. “We treat each insured person individually by listening to them and trying to reassure them as much as possible.“, she adds, specifying that the “fear of results” constitutes the main obstacle to screening.
Half of the applicants agree to be screened
The information collected by the advisors will be used to more broadly assess the obstacles to better guide communication campaigns.
Appointment times and mobility constraints also complicate access to screening. It is therefore still too early to know whether the insured have actually gone for screening by counting “the number of procedures reimbursed“, specifies Ms. Camblanne.
In a press release published in mid-May, the CPAM of Dordogne nevertheless assured that among the respondents, “half adhere to the approach“for colorectal cancer screening, and”A quarter” for breast cancer by making an appointment with the radiologist.
With AFP
