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Where the 30-60-90 Model Came From

By Richard Lippert, Founder, Mammologix

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In 1997, one of the first Mammologix client relationships was with a solo breast surgeon who was performing both screening and diagnostic mammograms in her own practice — approximately 1,050 patients a year. It was a small volume by any comparison to the health systems and multi-site programs that would come later. The discipline inside that practice was not small.

Working in that environment was different from working with a conventional breast imaging facility. Because the surgeon was directly involved in the patient's diagnosis, treatment planning, and ongoing care, the practice operated with an unusually strong orientation toward follow-through. Staff didn't just record that a patient needed follow-up — they worked to make sure the patient actually completed it. They called. They tracked. They escalated when patients went quiet. Follow-up was not a documentation task. It was a clinical responsibility.

The surgeon herself was a direct contributor to that philosophy. She made clear, in the way the practice operated and in what she communicated about her expectations, that identifying a gap in a patient's care was only the beginning. What happened after the identification was the work.

Identifying that a patient needs follow-up is only half the work. The other half is monitoring whether she returned — and continuing to reach her if she hasn't.

That principle, practiced daily in one small breast surgery practice, became the foundation for what Mammologix later formalized as the 30-60-90 day follow-up model.

The model is straightforward: if a patient does not return within the expected timeframe after a follow-up recommendation, she is identified as overdue. From that point, she is monitored and contacted at defined intervals — 30 days, 60 days, 90 days. Each interval triggers a structured outreach. The goal is not to generate documentation of attempts. It is to bring the patient back into care.

As Mammologix took on more clients, a common theme surfaced consistently. Facilities of every type and size were looking for the same thing: a way to monitor and navigate patients recommended for immediate or interval short-term follow-up — organized, easy to use, and structured to rank the priority of follow-up across multiple dimensions. The ask was the same whether it came from a community hospital or a health system affiliate. The 30-60-90 framework was the answer that had been taking shape since 1997.

Today, the 30-60-90 tracking framework supports both operational listings and patient communication programs across Mammologix clients. Facilities use it to identify overdue patients by time interval, generate outreach at each stage, and maintain a documented record of follow-up activity that supports both clinical continuity and audit readiness.

None of that started from a software requirement or a regulatory mandate. It started from watching a breast surgeon's staff refuse to let a patient fall through a gap — and recognizing that the discipline behind that behavior could be systematized and carried forward.

Mammologix has been working in breast imaging facilities for nearly 30 years. Most of what we know came from the people doing the work — and from paying close attention to what happened when the process worked and when it didn't.