Using an Integrated, Digital Framework to Standardize and Expand a Multisite Lung Cancer Screening Program.

Abstract

Lung cancer screening (LCS) is one of the most potentially impactful interventions of the past two decades for reducing lung cancer mortality. However, no current standard exists in the field for comprehensive data collection and tracking of LCS, despite availability of electronic health records (EHRs) and LCS management tools. In a widely expanding LCS program, harmonization of data becomes critical for decisions surrounding clinical care coordination and operational management. This article summarizes the implementation of an integrated, digital framework within the Jefferson Health System using the Epic EHR and its customized SmartForms as well as Research Electronic Data Capture application. Leveraging these tools has allowed for standardized documentation across the LCS process continuum for each patient: LCS eligibility, shared decision making, low-dose computed tomography, and follow-up. Since the initial rollout in October 2022, 11 program sites across four regional hubs have adopted this framework. A standardized process paired with interoperability between systems has resulted in a centralized data repository, increased communication and transparency within and between program sites, and decreased duplicative or manual processes across the entire LCS program. The resultant digital framework is poised for scale-up and sustainment across the Jefferson Health System, and it can also be replicated across other LCS programs. Future iterations of the current work or adoption by other programs should take into account the complexities of the EHR itself and data provenance to ensure success. Active participation among stakeholders for synchronous coordination of building, implementing, and troubleshooting a comprehensive repository for LCS data can ultimately facilitate measurement of quality metrics and develop future research in early detection of lung cancer.