Implementation of an Electronic Medical Record Alert Significantly Increases Lung Cancer Screening Uptake

• Published in: Clinical lung cancer 2024-11, Vol.25 (7), p.619-623
• Main Authors: Park, Ju Ae, Yalamanchili, Sriya, Brown, Zeliene, Myers, Andrew, Weyant, Michael J., Mahajan, Amit K., Connolly, Christopher Patrick, Suzuki, Kei
• Format: Article
• Language: English
• Subjects: Aged; Early Detection of Cancer - methods; Electronic Health Records - statistics & numerical data; Electronic medical record notification; Female; Humans; Improving cancer screening; Lung Neoplasms - diagnosis; Male; Mass Screening - methods; Middle Aged; Primary Health Care; Provider gap; Tomography, X-Ray Computed - methods
• ISSN: 1525-7304; 1938-0690; 1938-0690
• DOI: 10.1016/j.cllc.2024.08.002

Lung cancer survival is significantly improved with early detection. However, lung cancer screening (LCS) uptake remains low despite national recommendations. Our aim was to determine whether implementation of an electronic medical record (EMR) alert and order set would increase LCS uptake. A query of current and former smokers identified 62,630 patients aged 50 and above in the primary care setting between January 1, 2021 and May 5, 2022. We randomly reviewed 3704 charts for LCS eligibility and recorded who received LCS in the form of low-dose computed tomography amongst the eligible patients. We collected demographic information including gender, race, primary language, ethnicity, zip code, and insurance. Data analysis was performed utilizing 2-proportional z tests. We identified 461 patients who were LCS eligible. Our overall LCS uptake was 19.9% (92/461). Three-time frames were analyzed: (1) prior to EMR alert implementation, (2) after implementation of EMR alert (January 7, 2021), and (3) after implementation of EMR alert and order set (March 3, 2021). Screening uptake was significantly improved with initiation of EMR alert (1/46 [2.2%] to 23/109 [21.1%]; P = .003). LCS uptake remained similarly high after subsequent order set implementation (23/109 [21.1%] and 68/306 [22.2%]; P = .72). Amongst the different demographics, age was significantly associated with screening uptake, with age ≥65 demonstrating statistically significant increased rates of screening (15.6% [41/263] for