Proactive, Prediction-Driven Outreach for Lung Cancer Screening: Development and Feasibility of a Population Management Toolkit.

Abstract

Lung cancer screening (LCS) uptake is low and high-benefit patients often are not reached. This study developed and pilot tested a prediction-driven population management approach to proactively identify and engage high-benefit patients in LCS. This four-phase feasibility study included (1) formative interviews with clinicians and patients; (2) LCS population management toolkit development including a site-level dashboard displaying unscreened, LCS-eligible patients arranged by predicted LCS benefit derived from a validated multivariable model; (3) toolkit pilot testing by LCS coordinators at five sites; and (4) postpilot interviews. To ensure the toolkit was patient-centered and met clinical needs, we interviewed 14 LCS program clinicians, 6 primary care providers, and 18 patients in formative interviews and 8 LCS program clinicians in postpilot interviews. Transcripts were analyzed using rapid content analysis. Following user-centered design principles and focusing on key intervention elements, findings were applied to population management toolkit development. Clinicians and patients endorsed LCS population management with proactive outreach. Clinicians valued LCS coordinators using their expertise to engage high-benefit patients while reducing strain on primary care. Patients appreciated additional touchpoints and recommended clear outreach using letters and telephone calls, emphasizing team-based care and nonstigmatizing language. These insights informed development and refinement of an adaptable toolkit. After pilot testing, LCS coordinators reported positive experiences and suggested toolkit refinements. A prediction-driven approach to population management and proactive outreach is feasible and acceptable to clinicians and patients. Further studies should test the impact of this approach on LCS uptake and outcomes.