Low volumes, reimbursement concerns, and the challenge of managing patients' suspicious findings make it hard for organizations to maximize the return on investment of lung screening programs. This means that imaging leaders must develop a strong strategy to capture and grow volumes, and differentiate themselves from competitors. To help, we've compiled the most recent screening recommendations and strategies emerging from academic journals so that you can achieve program excellence.
Understanding screening recommendations
To target the correct patient population, first understand the reimbursement requirements for lung cancer screening, a low-dose computed tomography (LDCT). Both the United States Preventive Services Taskforce (USPSTF) and the Center for Medicare and Medicaid Services (CMS) released screening guidelines, summarized in the below table.
For more detailed information around patient qualifications and shared decision making requirements, review our lung screening frequently asked questions.
Recent insights driving lung cancer screening strategy
Now that you understand the patient demographic, find ways to differentiate your program from competitors. To improve your lung screening strategy, we've rounded up recent studies that propose new ways of caring for this important patient population.
1. Pinpoint optimal screening intervals
While reimbursement criteria provide a baseline, risk models can also identify optimal intervals to offer screenings based on unique patient characteristics and history. In a study published in Thorax, researchers analyzed the utility of annual screening exams and found that personalizing screening intervals of one or two years resulted in more appropriate resource use. They modeled the relationship of 11 variables, based on patient characteristics and previous CT screening results, against lung cancer diagnosis. Their analysis found that 10.4% of patients studied could have skipped the second year screening without a delay in cancer diagnosis.
Implications for screening programs: Consider integrating risk models into screening assessments to ensure patients receive the appropriate amount of exams based on coverage criteria, patient characteristics, and previous exam results. These efforts may reduce the frequency of CT exams for some patients, thus limiting radiation exposure.
2. Leverage artificial intelligence (AI) to improve reads
As with many imaging procedures, AI capabilities have the potential to improve lung cancer screening. Specifically, a study published in the American Journal of Roentgenology found that computer-aided detection (CAD) algorithms helped radiologists identify 15.5% more malignant nodules while decreasing reading time by 26%. Using ClearRead CT Solutions, a CAD algorithm that subtracts vessels, the researchers removed unnecessary clutter for a more streamlined read.
Implications for screening programs: While CAD is commonly used for breast imaging, leaders can also leverage the technology to improve lung cancer diagnosis and streamline radiologist workflow. The role of imaging AI continues to evolve, and leaders should stay abreast of trends to see how the technological advancements, such as CAD-assisted reads, can improve lung cancer patient outcomes.
3. Create a patient-centered follow-up strategy
Screening programs are incomplete without a strong follow-up strategy after a positive diagnosis. However, many patients experience lengthy delays – at times over 12 months – in scheduling the follow-up diagnostic exam due to personal, provider or payer-related issues. This has grave consequences; a study published in A Cancer Journal for Clinicians discussed evidence that longer intervals between positive screening tests and diagnostic exams can result in worse patient outcomes.
Implications for screening programs: Imaging programs must reduce delays so that patients can receive follow-up diagnostic PET-CT scans or biopsies in the recommended 60 days for lung cancer patients. To help, we've complied a suite of resources to manage patient communication and data. These efforts will reduce patient worry about the positive screening results, and shorten the time between detection and operation.
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