Table.

Summary of notable facilitators and barriers to implementation of a low-dose computed tomography lung cancer screening program at 2 pilot sites in West Virginia (Site A) and Tennessee (Site B), 2016-2018 ^a

Domain	Site A	Site B
Implementation process	Facilitators: Slow, stepwise approach working through challenges with individual payer groups Delay rollout to health care providers until after initial challenges resolved Barrier: Lengthy process	Barriers: Rapid rollout leads to numerous implementation challenges simultaneously Minimal communication of lessons learned when expanding to additional clinic sites
FQHC context	Facilitators: On-site breathing center and high level of knowledge of lung disease EHR customizable to track pack-years and issue health care provider reminders for lung cancer screening	Barriers: Competing priorities such as patient-centered medical home accreditation and EHR change Unable to modify EHR to track pack-years or issue reminders for lung cancer screening
Staff member engagement	Facilitators: Leadership buy-in and support Enthusiastic project champion who conducted internal pilot and provider education Barrier: Health care provider concerns about false-positive test results	Facilitator: Strong champion support at project outset Barriers: Low buy-in from leadership Project champion left FQHC Substantial staff turnover
Partner relations	Facilitator: Regular meetings to proactively address challenges	Barriers: Inconsistent meeting schedule Tense relationship after screening partner halted project temporarily

Abbreviations: EHR, electronic health record; FQHC, federally qualified health center.

^aEach pilot site consisted of an FQHC and an American College of Radiology–designated lung cancer screening center.