0:01

We also recommend that you use patient letters written in

0:04

lay language, which is generally recommended in healthcare

0:07

literacy to be at the seventh grade education level.

0:11

We send these in addition to the automatic release

0:14

of the radiologist report to the patient portal, which is

0:17

mandated that it's required under federal legislation,

0:21

the patients have timely access to their reports

0:23

and that they be released to them in a timely manner.

0:26

So for people using patient portals

0:28

and electronic health systems,

0:30

these are usually instantaneously released out

0:33

to the patient as soon as they've been signed

0:35

by the radiologist, up to maybe perhaps taking a few hours.

0:39

But we're required to do that by federal law.

0:42

The lay language letters are an opportunity for you

0:45

to educate the patient who came to you

0:47

for lung cancer screening about the importance

0:50

of lung cancer screening, as well as

0:52

to include other things such as the importance of

0:54

maintaining smoking, abstinence, or smoking cessation.

0:58

They'll also be reminded of why they got the scan

1:03

and what the next follow-up recommendation is.

1:06

So you can create versions of your lay letters

1:08

that reflect each

1:09

of the different lung Rads core categories, adjusting

1:13

to the different management timeframes and next steps.

1:16

So we have letters for Lung RAD zero lung RADS

1:19

for the negative screens one

1:21

and two, lung RADS three, four A four bx.

1:25

And we also have reminder letters if a patient hasn't come

1:29

in for their next annual screening, similar

1:31

to the reminder letters that are sent for mammography.

1:35

So we believe the patient letter is an important way not

1:38

just to communicate and understand to our patients

1:41

what the result is of their screening test,

1:44

but also to put it in context

1:45

of the next steps in management

1:47

and is an important part of reminding them to come back.

1:51

Here are some examples of letters

1:55

that we've put together to go to patients.

1:58

The one on the left is for our lung RADS one

2:00

and twos our negative screens.

2:02

And the one on the right is for our first level

2:05

of positive screen or lung RADS three,

2:08

where the recommendation is going

2:09

to be a six month follow-up low dose ct.

2:12

And you can see that we have built it in a way

2:14

that we can harness the power

2:17

of being in an integrated electronic health record.

2:19

So if you are, some

2:21

of this information can automatically fill from fields in

2:24

the EMR, so you'll see dear

2:26

and then this kind of structure for the name.

2:30

This will automatically important

2:31

for us from the electronic health record,

2:33

but there are other ways of generating these letters.

2:36

The important thing is to consider generating letters

2:39

to send the patients as a radiology practice.

2:42

You know, thank you for choosing us

2:44

for your lung cancer screening ct.

2:46

So we're showing gratitude to our patients

2:48

for getting their care at our location.

2:50

And the date on which the exam

2:52

below is a summary of the results.

2:54

A copy of the report has also been sent

2:57

to your primary care physician or

2:58

A foreign provider.

3:00

We give their name and by the time you receive this letter,

3:02

you may have already reviewed your test results in your

3:05

MyChart patient portal or been contacted by your provider

3:08

or their team about this.

3:09

So we're pleased to inform you the

3:11

important information in bold.

3:12

Pleased to inform you that the results

3:14

of your recent lung cancer screening CT did not show

3:17

any evidence of lung cancer.

3:19

And the attached report may also describe some

3:21

of those other important findings

3:23

that we've talked about already as incidental findings

3:25

for which they should discuss with their ordering provider

3:28

to determine if management

3:30

or referral is recommended for further evaluation.

3:33

And we set those stages for next steps.

3:36

A single screening exam is not a clean bill of health,

3:39

similar to the type of information you see in

3:41

screening mammogram reports.

3:42

Screening reduces the likelihood

3:44

of dying from lung cancer when done annually,

3:47

and we encourage you to contact your referring physicians

3:49

to determine if you remain eligible to continue screening.

3:52

And if so, to place an order so

3:54

that we can schedule your next annual lung cancer

3:57

screening CT a year from now.

3:59

And in our system for MyChart users,

4:01

they can do this for their patient portal.

4:03

So giving them the information about what to do next,

4:06

giving them ownership of the process.

4:08

Although a lung screening CT is very effective at finding

4:11

lung cancer early, they cannot find all lung cancers.

4:15

If you develop any new symptoms such as shortness of breath,

4:18

chest pain, or coughing up blood,

4:20

please call your provider again, giving them information

4:23

to help manage their health.

4:25

And then tobacco cessation.

4:27

If you're currently smoking or recently quit

4:29

and want help, please call our tobacco counseling service,

4:33

provide the information that you might have

4:35

for whatever service that you're using

4:37

or information about your state quitline.

4:39

There's an 800 quit now in every state that directs

4:43

to the state version of the National Quitline

4:46

as a great resource to direct patients.

4:49

And reinforcing that smoking cessation is the most important

4:52

thing you can do to improve your health

4:54

and reduce your chances of dying from lung cancer

4:57

and other things we've noted like cardiovascular disease.

5:00

So we're trying to be helpful to our patients, clarifying

5:03

and explaining the results of their tests in lay language

5:06

and other things that they should keep in mind

5:09

and actions that they can take to take ownership

5:13

of their screening test results in their own health.

5:15

And then for each of the positive screens,

5:17

we have additional information for lung RADS three.

5:20

For example, the recommended next step is

5:23

to repeat a chest CT using the same low radiation dose used

5:26

for your screening exam in six months.

5:29

If this hasn't been arranged, please contact your provider

5:32

to discuss these results

5:33

and take the next step in lung screening.

5:35

If you're in a centralized program, you may be the program

5:39

that is managing and scheduling these

5:41

and you could put your own information there instead.

5:44

So again, I just wanna reinforce the importance

5:46

of putting information in the lay context that is adjustable

5:50

and understandable and helping patients take

5:52

ownership of their information.

5:54

It creates a wonderful opportunity

5:56

For, for you as a radiology practice to be a part

6:00

of the patient care spectrum

6:02

and taking care of patients with lung cancer

6:04

and putting you front and center as a radiology practice.

6:09

We also have a reminder letter that goes out

6:12

and ours are generated through our electronic health record

6:15

as to for patients who've missed that next annual screening.

6:19

And so this will go

6:20

to them either automatically in their patient portal

6:23

or a letter if they're not enrolled in the patient portal.

6:26

Again with discrete information

6:28

that's gonna be important to them.

6:30

Here's the date. We put their patient name

6:32

and address, like a letter, their medical record number,

6:35

and we copy their ordering provider

6:37

and basically let them know

6:38

that our records indicate you were due

6:40

for your next screening exam on or

6:42

or around whatever that date is,

6:45

and that they should please take the next steps.

6:47

Call your primary care physician or ordering provider.

6:50

We give them the name of the one they saw last

6:52

for lung screening to order your exam

6:54

and schedule the appointment.

6:56

So if they're not interested in continuing

6:59

or not eligible, they can also contact as well.

7:02

Contact us as well

7:03

to take 'em off the annual screening reminders

7:06

and then again, reinforcing some of

7:07

that educational contact from the early letters.

7:11

And then the last thing I'll say

7:12

that's really helpful when you have structured reports is

7:16

that when you have information in a template

7:18

and manner in your reports, you can use it to extract

7:21

that information to understand your patient practice.

7:24

And you can also use it in your patient management

7:26

and data tracking software.

7:28

If you're using that, you might have a tool in your

7:31

electronic health record

7:32

that helps you track your lung cancer screening

7:34

and incidental nodule patients.

7:36

You may have a third party software tool that helps you do

7:39

that, but by using these, there are some things

7:41

that you can should consider.

7:43

Consider the feasibility of implementing for your practice,

7:46

a tool like this and the cost.

7:48

Take careful consideration about the functionality

7:51

that you want to be able to make sure people are coming back

7:54

and getting their follow-ups

7:55

and being able to track their journey

7:57

with nodules over time.

7:59

And how does it work with your own technology?

8:02

Think about the impact it's gonna have on your workflow

8:04

and who's actually gonna manage this tracking software

8:07

and do the patient navigation around it.

8:10

These types of tracking software can help you submit

8:13

information to registries, even if it's your local one

8:16

or something like the A CS registry.

8:18

And they're also helpful when you have a tracking tool

8:21

to look at your practice performance.

8:23

You should also consider things about if you're going

8:26

to implement a tool, what sort of training

8:28

and support is available,

8:30

what are the future development plans

8:32

that the company might have

8:33

that you're considering using their tool from?

8:36

How easy is your user interface?

8:39

How well does it catalog and collect data

8:41

and allow you to slice and dice your information?

8:44

How much manual entry is still required even though it's a

8:48

relatively automated system.

8:50

Think about end user autonomy over platform

8:53

configuration letter updates,

8:55

And think about the security of any tool that you're going

8:58

to implement both for your system

9:00

and personal health information security.

9:02

So patient tracking tools are great to have.

9:05

They build off having structured reports

9:07

to extract information,

9:09

and they're very useful for making sure

9:10

that your patients come back for the followup

9:13

of screen detected abnormalities

9:15

and the followup of incidental pulmonary nodules as well

9:18

as you work towards early lung cancer detection.

9:22

So with that, thanks for sharing a few moments of your time,

9:25

talking about reporting considerations in your lung cancer

9:28

screening CT exams.