Developing a Health System-Based Learning Community to Increase Lung Cancer Screening

Authors: DiCarlo M, Lambert E, Myers P, Brawer R, Giamboy, Garber G, Zeigler-Johnson C, Juon HS, Hegarty S, Daskalakis C, Evans N, Kane G, Myers, RE

Category: Early Detection & Risk Prediction
Conference Year: 2020

Abstract Body:
Purpose: The Centers for Medicare & Medicaid Services approved coverage of lung cancer screening in 2015, but screening rates remain low, a problem that has especially unfortunate implications in populations experiencing lung cancer disparities. In 2018, a large urban health system embraced the challenge of increasing screening in vulnerable populations by launching the Lung Cancer Learning Community (LC2) Initiative. Methods: Based on constructs drawn from the Interactive Systems Framework for Dissemination and Implementation and the Collective Impact Model, health system personnel engaged patients, providers, organization leaders, and community stakeholders to work toward achieve the following aims : 1) Develop a novel lung cancer screening outreach program for diverse populations at increased risk for lung cancer, 2) Implement the outreach program to enhance existing health system lung cancer screening activities, and 3) Evaluate outreach program implementation processes and outcomes. Progress in infrastructure operationalization and aims achievement are presented here. Results: We formed an infrastructure that includes 92 members and who serve on a Strategic Management Team (SMT), Coordinating Team (CT), Steering Committee (CT), Patient and Stakeholder Advisory Committee (PASAC), a Research and Evaluation Committee (REC), and a Policy Group (PG). Learning community members are working together to develop and pilot test interventions intended to raise lung cancer screening rates in populations served by the health system. Using a Consolidated Framework for Implementation Research-grounded approach, the learning community developed a multi-level screening outreach strategy targeting primary care practices and patients to receive a mailed and telephone Education, Assessment of eligibility, and Shared decision making Intervention (EASI). The patient-level EASI strategy is being pilot tested in an institutional review board (IRB)-approved study that involves four health system primary care practices and 2,500 patients identified through electronic health records as being current or formers smokers and who are 50 to 80 years of age. Conclusions: The learning community has developed a multi-level outreach intervention that targets primary care practices and

Keywords: Lung cancer screening, health education, healthcare delivery