suzanne lenz wendy oliver caitlyn macglaflin, sarah mcdougall, melissa friedman
TRANSCRIPT
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IMPLEMENTING LUNG CANCER SCREENING AT D-H
Current Methods
Suzanne LenzWendy Oliver
Caitlyn MacGlaflin, Sarah McDougall, Melissa Friedman
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Suzanne Lenz and Wendy Oliver have no actual or potential conflict of interest in relation to this program or presentation.
DISCLOSURE
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All patients will go through agreed upon process based on USPSTF recommendations.
Informed decision making major part of the process.
COMMITTEE GOALS
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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
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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
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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
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33% Coordinator Time◦ funded through June 30 by Cancer Center
Existing “Resources” Utilized◦ Interdisciplinary Thoracic Oncology Clinic◦ CT Surgery ◦ Radiology◦ Cancer Center
RESOURCES
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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
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All referrals/requests routed to SAL for intake and process initiation
SAL
CP order query
D-H provider
Outside provider
Patient
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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
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Part 1
SAL
• 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 Scree
n
• Review Results• Determine next steps for patient• Results to patient + provider• Arrange follow-up per provider preference
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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.”
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Part 3Coordinator Pool
• Quality Measures
Part 4Coordinator
• Final check• Immediate / near term follow
up arranged• All data logged for tracking
+ patient notifications
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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
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