Virtual Library

Start Your Search

Johanne Leblanc



Author of

  • +

    P2.11 - Screening and Early Detection (Not CME Accredited Session) (ID 960)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/25/2018, 16:45 - 18:00, Exhibit Hall
    • +

      P2.11-25 - Lung Cancer Screening Implementation in Community Practice: Kaiser Permanente Washington Experience 2015-2018 (ID 14210)

      16:45 - 18:00  |  Author(s): Johanne Leblanc

      • Abstract
      • Slides

      Background

      We describe the implementation of lung cancer screening program at Kaiser Permanente Washington (KPWA), an integrated medical insurer and healthcare provider in Washington state. Since the US Preventive Services Task Force recommendation to screen for lung cancer, data is scarce on the implementation of community experience with lung cancer screening, and whether community experience is like the experience in clinical trials.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      We purposefully employed a soft-launch of our lung cancer screening program with low-dose CT (LDCT) so we could rapidly evaluate our experience through audit and feedback. The program began in January 2015 and included several key implementation components: 1) guideline review supporting lung cancer screening; 2) continuing medical education to physicians regarding implementation; 3) Epic-registry build to account for eligible members, orders for LDCT, completion of LDCT, and radiologic results; 4) Nurse care coordinator to follow-up with screen positive members to return for imaging; 5) Development of a shared decision making tool for patient/provider discussions. LDCT is read by radiologists using American College of Radiology Lung-RADSTM grading system. We describe the uptake of LDCT in an age- and smoking-eligible population and alignment of Lung-RADSTM with expected population estimates overall among exams conducted from 2015-2018. Negative screen is defined as Lung-RADSTM 1 or 2. Positive screen includes Lung-RADSTM 3 and 4.

      4c3880bb027f159e801041b1021e88e8 Result

      With an estimated 15,000 adults eligible for lung cancer screening, about 1,800 annual visits have a documented shared decision-making. While the majority of patients (89%) opt-in to screening, about 26% of those patients cancel or do not show up for their LDCT exam. As of March 2018, KPWA completed 3,092 LDCT exams: 2,104 initial screens and 988 subsequent screens. Among all initial LDCT performed, 84.6% screened negative; the proportion increased slightly to 88.6% on subsequent LDCT exams. On initial LDCT, the proportion of positive exams were as follows: Lung-RADSTM 3 (7.8%); Lung-RADSTM 4A (3.3%), and Lung-RADSTM 4B, C, X (2.4%). On subsequent LDCT exams, these proportion decreased slightly to 5.2% and 2.2% for Lung-RADSTM 3 and 4A, respectively.

      8eea62084ca7e541d918e823422bd82e Conclusion

      Overall implementation of KPWA lung cancer screening suggests an ability to identify eligible patients, engage in shared decision-making, appropriate referral and uptake of LDCT, appropriate use of Lung-RADSTM assessment, and patients who return for follow-up and subsequent annual screening. Opportunities remain for improvement in acceptance of LDCT based on patient needs and further adoption within our system.

      6f8b794f3246b0c1e1780bb4d4d5dc53

      Only Active Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login or select "Add to Cart" and proceed to checkout.