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Breast cancer screening

Residents of Bonaire are invited to participate in a biennial breast cancer screening programme aimed at early detection. Mammography images are acquired locally at Fundashon Mariadal by trained laboratory staff. These images are then securely transmitted to the Netherlands, where specialised screening radiologists at Amsterdam University Medical Center assess them for abnormalities. The results are subsequently communicated back to Bonaire, where general practitioners and screening coordinators inform patients and coordinate any required follow-up. If further diagnostics or treatment are needed, care may be provided locally or arranged in Curaçao, Aruba, or the Netherlands. The programme is coordinated by the National Institute for Public Health and the Environment (RIVM), in collaboration with local screening organisations and healthcare providers.

This use case clearly demonstrates the potential of cross-border healthcare by leveraging laboratory capacity and clinical expertise across the Caribbean and European Netherlands, enabling high-quality care despite geographic fragmentation.

Challenge today

  • Coordination between local screening, international radiologists, and follow-up care is complex
  • Imaging data must be securely transferred across borders for interpretation
  • Delays may occur due to logistics and data exchange between systems
  • Limited interoperability increases reliance on manual processes and coordination

Desired situation

  • Screening images and results can be shared seamlessly across borders
  • Radiologists can access high-quality imaging data without delay
  • Results are communicated quickly and reliably to local healthcare providers
  • Patients receive timely follow-up care in the most appropriate location

Required capabilities

  • Patient identification across organisations and countries
  • Secure exchange of imaging data and reports
  • Standardised formats for imaging and diagnostic results
  • Coordination of screening, interpretation, and follow-up processes
  • Traceability of data and clinical decisions
  • Patient Identity
  • Health Data Exchange
  • Imaging Data Exchange
  • Terminology & Semantics
  • Audit & Logging

Impact

  • Earlier detection of breast cancer through efficient screening processes
  • Faster communication of results and follow-up actions
  • Improved patient safety and continuity of care
  • More effective use of specialised radiology expertise across regions
  • Better health outcomes through timely diagnosis and treatment