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As a radiologist, it's important to know

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what your role is in lung cancer screening,

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and importantly, what's the role of your radiology practice.

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There's no one single way to do this.

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We know that radiologists are responsible for performing,

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interpreting, and overseeing the quality

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of the lung cancer screening CT exams,

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and that can be the totality of your engagement.

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But in many places, radiology practices are leading lung

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cancer screening programs

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and playing an important role in finding people

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who are eligible for screening

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and communicating directly with patients.

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As a patient-centered radiology

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practice, the choice is yours.

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We'll talk about some different program models

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for lung cancer screening,

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and you can see how you may fit in.

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Your role can be leading co-leading

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or participating in the lung cancer screening program, core

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to interpreting, overseeing image quality

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and radiation exposure.

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Recruiting patients through parts

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of your practice like co recruiting

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through your screening mammography program

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and using patient first.

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Non-stigmatizing language are all things

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that all radiology practices should do,

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but you can play a bigger role in leading the program.

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Importantly, I'm gonna talk about how you can figure out

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what resources are important

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and how to make the case to get those resources

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to support your lung cancer screening program.

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In other words, the financial side

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of supporting your program.

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There are many different program models

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for lung cancer screening,

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and the most common are referred to as centralized programs

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and decentralized programs,

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but in reality, there is a hybrid

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continuum between these two.

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In a centralized lung cancer screening program,

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the program manages much of the activities for the patients.

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The primary care physician may refer the patients directly

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to the central program,

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and that central program does the shared decision

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making with the patient.

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Make sure that smoking cessation counseling is happening.

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Orders the CT scan manages the results

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and oversees everything from quality

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and eligibility in their population, as well

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as insurance coverage and reimbursement.

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So everything is handled centrally by a central team,

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and that team may be led by a radiologist

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or radiology department.

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It may be led by a pulmonary medicine physician,

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a thoracic surgeon, or a primary care physician.

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Whatever is right for a practice, a facility,

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or a locale is important to consider.

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Who wants to lead the lung cancer screening program?

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Who wants to put in the time who sees it?

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An important part of their practice usually decides

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where the program is going to be centralized.

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If it's a centralized program in this structure,

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the radiologist, if they're not leading the program,

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are responsible for those core elements

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of the CT scan itself.

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In a decentralized program,

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A primary care physician may have a patient

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who's eligible for screening.

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They conduct shared decision making,

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and they're responsible for making sure

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that smoking cessation services occur.

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They then send the order to you as a radiology practice

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to perform and interpret the CT

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and to oversee that examination from a quality perspective.

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You then send a result back

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to the primary care physician indicating the result

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of the test and any next steps.

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The onus is then on the primary care physician

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to order the next annual lung cancer screening ct,

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so this will be considered a decentralized program.

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In reality, there are elements of both.

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In many programs, there are very good examples

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of hybrid programs, so finding a program structure

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that is right for you as a radiologist in radiology practice

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is important as to what your role is in your facility.

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And as I mentioned, there's no right answer to

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what the organizational structure is.

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Many people believe that a centralized program is going

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to deliver better results for patients

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because they manage the entire program from beginning to end

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for a patient making sure

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that nothing slips through the cracks.

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In a decentralized program, it may be harder to make sure

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that things don't fall through the cracks

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because they're essentially too loci of responsibility.

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The locus that is the primary care physician ordering a test

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and the radiologist or radiology practice performing the

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test and making sure there's some connection so

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that patients come back for follow-up testing

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and come back for annual screening, becomes really important

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for you to coordinate.