Developing a community hospital lung screening program

A community hospital in Indiana recently implemented a comprehensive lung screening, smoking cessation program and multidisciplinary thoracic oncology clinic, and detailed its experiences in an article published online Feb. 12 by the Journal of the American College of Radiology.

Elkhart General Hospital was faced with an issue: over the previous ten years, 50 percent of lung cancers diagnosed at the facility were at stage IV, which is higher than the national average. After identifying smoking as a prominent health concern for the area’s local residents, staff at the hospital developed a lung screening and cessation program, as well as a thoracic oncology clinic.

The screening program followed single patients for several years, enabling easy entry points and detailed check points within the system. High-risk individuals are identified for CT, and low-income patients with no insurance are covered for screening costs through a hospital grant.

Patients are screened with an LDCT protocol in order to achieve dose optimization. Each patient is then called to discuss his or her exam results, as well as to provide the opportunity for an appointment for smoking cessation counseling. Written radiology reports are consistent and clear to ensure the program’s success.

A structured reporting system, referred to as L-RADS, was created by the program designers to ensure uniformity amongst the radiologists and referring providers.

In the first 13 months of the program, 150 patients have been screened. Of those screenings, 100 patients were recommended for 12 month follow-up, 28 for six month follow-up, 11 for three month follow-up, and two for biopsy.

The program designers plan on promoting and tracking the smoking cessation counseling with office practitioners and offering LDCT lung screening for patients with high-risk smoking histories.

“It is our hope that sharing our experience will facilitate the development of similar programs to the benefit of all our patients,” wrote the article’s lead author, Samir Patel, MD, of Radiology, Inc, in Mishawaka, Indiana, and colleagues.