By Nancy DeSando and Susan Phelan
Implementing a low-dose lung cancer screening (LCS) program can be a major endeavor.
From developing a workflow process, to educating referring physicians, to promoting and attracting screening candidates, a successful LCS program implementation is like a journey and it requires an effective data management strategy.
If you’ve already embarked on a low-dose LCS program, you may have encountered some of these data management hot topics:
1. You use spreadsheets to manage screening data
It might be a quick fix for getting started, but managing screening data in spreadsheet tools such as Microsoft Excel proves difficult and frustrating when assigning codes for even the simplest data, such as gender, or cross-referencing numbers. Any cost savings from using an existing tool are drained by the time required to enter coded data in a sheet, create a flat file, and upload to the American College of Radiology (ACR) for reimbursement by the Centers for Medicare and Medicaid Services (CMS).
Another cause for concern regarding spreadsheet submission is the potential for missed data. Often, missing data elements are not identified until after a file is sent to the ACR Registry.
Using a data management tool with an intuitive entry workflow can help to avoid missed data. The ACR Lung Cancer Screening Registry site lists the certified software partners with solutions for managing screening data for proper reimbursement and the ability to electronically upload screening data to the ACR in a simple step.
2. You gather and enter screening data by accessing various systems/databases
Are you spending hours copying data from various workstations and databases and pasting it into your spreadsheets?
Utilizing Health Level 7 (HL7) interfacing from your Health Information System (HIS)/Electronic Medical Record (EMR) or Radiology Information System (RIS) can help capitalize on sending the required elements to your screening data management tool. This can save time if the defined data are available within your network. The pre-population of patient data into the tool can enhance your process workflow and reduce the manual effort needed to capture the required patient data. The workflow process should be defined, and all locations educated to ensure consistency.
Also, consider acquiring a screening data management tool to ensure data completeness, consistency, and accuracy. The use of a screening data management tool can also help to avoid the risks of missing information and the necessity to resubmit screening data, and optional elements such as incidental findings found through the screening process can be efficiently documented for communication to the ACR.
Furthermore, when screening data are gathered locally across multiple screening locations in your network, it may be difficult to centralize the data efficiently.
3. You don’t have the time to deploy a new data management tool or train your users on it
Clinical software applications have a reputation as expensive and time consuming to install. Professional services used to be required for implementation and user training, escalating costs.
However, newly released applications are web-based, cloud-based, and self-installable. These solutions offer the ability for local administrators to choose which optional elements are also collected.
4. You don’t have time or resources to coordinate patient follow up
With a small patient population, it may be possible to track and follow up with screening patients. In an IMV study, LDCT Lung Cancer Screening Programs: Navigating the Path Toward Population Health, a western rural hospital with less than 200 beds and few screening cases reported, “We have such a small population that tracking and follow up are easy using our EMR … in our case, following two a month is simple.”
However, with a large number of patients to track, a southern imaging center-multispeciality clinic reported, “We had a system that we were doing manually to track the patients … backlogged almost 300 patients.”
An IT system or application would help streamline the patient tracking process and help with patient follow up: letters to alert the patient of their exam result and letters to remind patients to return for follow up appointments.
5. You cannot perform adequate reporting
Can you run reports from Microsoft Excel? Certainly. You can devise simple charts and graphs for depicting data. However, it may take more effort to combine spreadsheets from multiple ACR submissions and continue to track the program as you add more patients into your screening program.
Some of the screening data management tools contain good analytics features that can accommodate patient data over time for follow up appointments and data in subsequent years. This can help your organization to understand the overall health of your population and the success of the screening program.
Managing the data in your LCS program can be challenging. However, through organizations such as the ACR, support is available, and tools exist to not only manage the data but to help optimize your screening program results.
About the authors: Nancy DeSando, RT(R)(M), CIIP, is senior product manager for Siemens Healthineers. Susan Phelan RTR(CT) is CT manager for South Jersey Radiology Associates, an organization with 7 of 12 medical imaging locations in southern New Jersey providing lung screening.