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Drew Moghanaki
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EXH01 - Bristol-Myers Squibb Foundation Exhibit Showcase Session - Adressing Inequities in Care and Support for Lung Cancer Patients In The Us and Africa: Lessons and Challenges From the Front Lines (ID 384)
- Event: WCLC 2019
- Type: Industry Symposia & Workshops
- Track:
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2019, 12:00 - 13:15, Exhibit Hall
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EXH01.06 - How do we track it? The VAPALS-ELCAP Open Source Lung Screening Management System: Implications for Global Partnerships to Improve Lung Screening Access, Safety, and Efficacy (ID 4049)
12:00 - 13:15 | Presenting Author(s): Drew Moghanaki
- Abstract
Abstract not provided
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OA06 - Refining Lung Cancer Screening (ID 131)
- Event: WCLC 2019
- Type: Oral Session
- Track: Screening and Early Detection
- Presentations: 1
- Now Available
- Moderators:Tomasz Grodzki, Lluis Esteban Tejero
- Coordinates: 9/09/2019, 11:00 - 12:30, Hilton Head (1978)
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OA06.03 - An Open Source Lung Screening Management System (Now Available) (ID 1467)
11:00 - 12:30 | Author(s): Drew Moghanaki
- Abstract
- Presentation
Background
Starting in 1992, the Early Lung Cancer Screening Project (ELCAP) investigators developed the ELCAP Management System (MS) to ensure high quality care and follow-up of the first 1,000 ELCAP participants. The resulting Lancet publication in 1999 created worldwide interest in screening and an updated web-based ELCAP MS was updated to be web-based and provided free of charge to participating institutions, together with the I-ELCAP protocol.
Method
The ELCAP MS was designed to be comprehensive and rapidly capture information on each participant to be used by coordinators, navigators, nurses, radiologists, and other medical professionals to ensure appropriate follow-up and care. It provides rapid documentation of telephone or other inquiries, registering, scheduling screening appointments, reporting results, diagnosis of lung cancer, and treatment, and archives all CT images for integrated access of image and patient information. It has been iteratively updated through user feedback, and supports medical reimbursement requirements and continuous quality improvement to minimize harms of lung screening across International ELCAP (I-ELCAP) sites.
Result
More than 81,000 participants in 80 institutions worldwide have contributed their LDCT findings and images. The MS has provided efficient data collection for rigorous assessment of screening outcomes which has resulted in some 300 publications and abstracts for protocol updating, comparisons, and continuous quality improvement.
Having anticipated “open science”, the ELCAP MS has been translated into an open source MS that offers a reference standard for data elements (1,500 data fields, 267 required) for robust and efficient management of lung screening programs. This first open source translation has been adopted by the United States Veterans Administration (VA) and integrated into its VistA Electronic Healthcare System for deployment at 10 VA medical centers through a grant for VA Partnership to increase Access to Lung Screening (VA-PALS). The software is being certified by the Open Source Electronic Health Record Alliance (OSEHRA); source code is available on GitHub.
Automated quantitative tools have been developed for identification and characterization of nodules, emphysema, major airways, calcification scoring of coronary arteries, aortic valve, thoracic aorta, breast tissue, liver, bone, and image quality. These tools are integrated into the ELCAP MS, and in the future will provide automatically-generated quantitative LDCT reports.
Conclusion
The ELCAP MS and I-ELCAP protocol have helped define current global standards for lung screening. Its developers have now made the ELCAP MS publicly available through OSEHRA for support of lung screening programs of any scale throughout the world.
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P2.11 - Screening and Early Detection (ID 178)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Screening and Early Detection
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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P2.11-33 - Organizational Readiness for Implementation of Lung Cancer Screening in a Veterans Affairs Healthcare System (ID 709)
10:15 - 18:15 | Author(s): Drew Moghanaki
- Abstract
Background
Implementation of high quality lung cancer screening is complex and requires close coordination between radiology and primary care teams. Organizational readiness for change (ORC) is an important factor in successful implementation of complex healthcare programs such as lung cancer screening. Using the Consolidated Framework for Implementation Research (CFIR), we tested the hypothesis that ORC would differ between radiology and primary care prior to deployment of a centralized lung cancer screening program.
Method
We conducted a cross-sectional observational study. We invited all radiology and primary care providers (hospital and community-based) and affiliated staff at a single large VA Healthcare System in the US by email to participate in a web-based survey. We measured demographic information and adapted 9 validated items on ORC (domains of change commitment and change efficacy) and 10 items on change valence (value of a planned organizational change) using a 7-point Likert-type scale. Respondents’ ORC and change valence scores were calculated by averaging individual item responses for each scale. The primary outcome, ORC, was evaluated as a continuous variable with higher scores representing more readiness. We compared mean ORC scores between radiology and primary care using independent 2-sample t-tests.
Result
The overall response rate was 54% (76/128 [59.4%] radiology, 206/398 [51.8%] primary care). After 12 respondents were excluded for incomplete data (5 from radiology and 7 from primary care), the analytical sample was 270 respondents. Respondents were on average 47 years old [SD 11.24], 72% female, and 17% self-identified as having a leadership role. Individuals affiliated with radiology reported higher ORC than those affiliated with primary care (5.50 [SD 1.42] versus 5.07 [SD 1.22], p=0.03). Individuals self-identifying as having leadership roles in implementation of lung cancer screening reported higher ORC than those without leadership roles (5.56 [SD 1.38] vs 5.11 [SD 1.28], p=0.05). Those with leadership roles reported higher change valence than those without (5.91 [SD 1.20] vs. 5.36 [SD 1.88], p=0.006). We found no difference in reported change valence between radiology and primary care.
Conclusion
Radiology providers and staff have higher perceived ORC to implement a centralized lung cancer screening program compared to primary care. Providers and staff with implementation leadership roles reported higher ORC than those without leadership roles. Understanding these differences in readiness will inform future work as we focus on strategies to engage primary care providers and staff during implementation of lung cancer screening. We will deploy these strategies at Veterans Health Administration facilities across the US with the support of the VA-Partnership to increase Access to Lung cancer Screening (VA-PALS) and the VA Office of Rural Health.
