IMPLEMENTING LUNG CANCER SCREENING AT D-H Current Methods
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Transcript of IMPLEMENTING LUNG CANCER SCREENING AT D-H Current Methods
IMPLEMENTING LUNG CANCER SCREENING AT D-H
Current Methods
Suzanne LenzWendy Oliver
Caitlyn MacGlaflin, Sarah McDougall, Melissa Friedman
Suzanne Lenz and Wendy Oliver have no actual or potential conflict of interest in relation to this program or presentation.
DISCLOSURE
All patients will go through agreed upon process based on USPSTF recommendations.
Informed decision making major part of the process.
COMMITTEE GOALS
Correct exam /correct order Patients meet all eligibility requirements All patients participate in informed decision
making Educate referring providers on our process
◦ Provide Clinic Profile and patient education materials
Keep providers informed◦ Patient “self refers”◦ Patient’s status within the process
Schedule screening exams in a timely manner
COMMITTEE GOALSbefore screening
Each screening result is reviewed by coordinator
Referring provider and patient receive results
Patient and provider receive and understand follow-up recommendations
Immediate or near term follow up recommendations are tracked and expedited
Quality measures are obtained
COMMITTEE GOALS after screening
Offer and arrange smoking cessation counseling◦ For all patients – eligible or not
Inform patients of financial issues
Assist patients without a PCP or insurance
Educate / inform ineligible patients re: low risk
Determine patient interest in future research
Develop and maintain database◦ Patient data, tracking, quality measures/improvement
ADDITIONAL GOALS
33% Coordinator Time◦ funded through June 30 by Cancer Center
Existing “Resources” Utilized◦ Interdisciplinary Thoracic Oncology Clinic◦ CT Surgery ◦ Radiology◦ Cancer Center
RESOURCES
4-Part Process ◦ 7 page word document (text + drop down menus)◦ Shared on secure folder - Radiology I:Drive
Two “pools” or teams
◦ Screening Access Line (SAL) 3 staff members
◦ Coordinator Pool (CP) Currently 1 staff member
◦ Communication via eDH In-Basket system
CURRENT METHODS
All referrals/requests routed to SAL for intake and process initiation
SAL
CP order query
D-H provider
Outside provider
Patient
Source of Intake to Screening Process
1. eDH Workbench and Image Cast queries: CP D-H providers Can “catch” ordered and scheduled exams Reviewed and routed to SAL
2. Outside or direct provider calls & referrals to SAL
3. Patient inquiry for self or family member to SAL CP informs / communicates with D-H providers SAL informs outside providers
METHODS CONTINUED
Part 1SAL
• Collect patient / provider / eligibility data• Patient educational materials sent• Inform providers: self referrals + program
process +patient materials + order
Part 2CoordinatorPre Screen
• Confirm eligibility + medical / imaging history
• Informed decision making• Address patient questions• Schedule screening exam
Part 2 After Screen
• Review Results• Determine next steps for patient• Results to patient + provider• Arrange follow-up per provider preference
Review statement with patient: “I understand that I am at increased risk to develop lung cancer and may benefit from screening for lung cancer with low-dose chest CT. I also understand that there are both potential benefits and harms to screening. I have had an opportunity to ask questions about the screening process. I agree to be screened with the reports sent to me and to my provider.”
Part 3Coordinator Pool
• Quality Measures
Part 4Coordinator
• Final check• Immediate / near term follow
up arranged• All data logged for tracking
+ patient notifications
Transfer process form to an eDH system
Track patients in eDH◦ Status during screening process◦ Follow up after screening
In conjunction with other disciplines, develop Lung Cancer Screening Registry
Process improvement
FUTURE DIRECTIONS