Table 1.
Characteristics of health systems and lung cancer screening program at participating Cancer Research Network sites
| HFHS | KPCO | KPNC | KPSC | |
|---|---|---|---|---|
| Characteristic of the health system | ||||
| Location | Metropolitan Detroit | Denver/Boulder and Front Range, Colorado | Northern California | Southern California |
| Members/population served, n | 700,000 | 625,000 | 3,700,000 | 4,200,000 |
| Medical offices, n | 33 | 24 | >200 | >200 |
| Hospitals, n | 5 | 3 (contract) | 21 | 14 |
| Sites where LDCT is performed, n | 9 | 3 | 23* | 24 |
| EHR system | Epic | Epic | Epic | Epic |
| Characteristics of the lung cancer screening program | ||||
| Year screening was first introduced | 2011† | 2014 | 2014 (pilot) | 2014 |
| Dashboard alert present in EHR to flag eligible patients | No | Yes | No | No |
| Electronic consult mechanism to process referrals | No | Yes | Yes | No |
| Standardized electronic order set | Yes | Yes | No | Yes |
| Method to confirm eligibility for screening | Checklist in order set‡ | Checklist in order set | Checklist in electronic consult‡ | Checklist in order set |
| Coordinator or navigator to confirm eligibility and/or facilitate care | Yes | Yes | Yes§ | No |
| Tools available to facilitate referral for smoking cessation | Yes | Yes | Yes | Yes |
| Scans interpreted by dedicated chest radiologist | Yes | Most | Some | Some |
| Lung-RADS used to report screening test results | Yes | Yes | Yes | Yes |
| Population-based outreach to patients who meet eligibility criteria | Yes (as of March 2017) | No | No | No |
| Approaches to implementation | ||||
| Initiated and sponsored by executive leadership | Yes | Yes | Yes | Yes |
| Based primarily in primary care practices | Yes | Yes | Yes | Yes |
| Mandatory participation by PCPs | No | Yes | No | No |
| Formal link to smoking cessation program(s) | Yes (as of May 2017) | Yes | No | No |
| Formal link to QI program(s) | No | No | Yes | No |
| Metrics to evaluate provider performance | No | No | No | No |
Definition of abbreviations: EHR = electronic health record; HFHS = Henry Ford Health System; KPCO = Kaiser Permanente Colorado; KPNC = Kaiser Permanente Northern California; KPSC = Kaiser Permanente Southern California; LDCT = low-dose computed tomography; Lung-RADS = Lung CT Screening Reporting and Data System; PCP = primary care physician; QI = quality improvement.
LDCT was performed at five sites during the pilot study period.
Prior to 2011, HFHS was an enrollment site for the National Lung Screening Trial.
Original check box format subsequently converted to free-text data entry to improve accuracy of smoking information.
KPNC adopted a navigator model near the end of the pilot testing/data collection period.