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The purpose of this quality improvement project is to conduct and evaluate the effect of sending an electronic reminder message to patients who qualify for lung cancer screening, haven't had a screening previously, and who have an upcoming scheduled appointment with their doctor.
United States Preventive Services Task Force (USPSTF) lung cancer screening (LCS) guidelines recommend LCS for those aged 50-80 with at least 20 pack-years smoking history, who currently smoke or quit within the last 15 years. In 2023, our study team found that there are approximately 6,000 - 8,000 Kaiser Permanente Colorado (KPCO) members who are unscreened and eligible for lung cancer screening (LCS). In support of KP's Population Health priority initiative to expand lung cancer screening participation for those who are eligible, our study team was selected to move this work forward in 2024 with feasible implementation opportunities for the KPCO LCS Operational/Institute for Health Research partnership at its core. The primary objective of this project is to conduct and evaluate a randomized quality improvement pragmatic intervention of a 2-arm electronic message outreach to unscreened LCS members who are eligible for LCS and who have an upcoming scheduled Primary Care Provider (PCP) visit.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Birth year = odd | No Intervention | No intervention, care as usual | |
| Birth year = even AND active on KP.org | Experimental | Has an upcoming primary care visit, qualifies for lung cancer screening based on USPSTF criteria, receives an electronic letter via KP.org informing that they qualify for LCS and reminding to talk to PCP about LCS at next visit. |
|
| Birth year = even AND not active on KP.org | Experimental | Has an upcoming primary care visit, qualifies for LCS based on USPSTF criteria, receives a mailed letter informing that they qualify for LCS and reminding to talk to provider about LCS at next visit. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Patient nudge | Behavioral | Patient receives an electronic or paper letter 'nudge' to talk to dr about LCS. |
|
| Measure | Description | Time Frame |
|---|---|---|
| The proportion completed a visit with a Primary Care provider by receipt of an electronic letter or paper letter | The proportion completed a visit with a Primary Care provider by receipt of an electronic letter or paper letter | 12 months |
| The proportion receiving an order to get a low-dose computed tomography (LDCT) lung cancer screen (LCS) scan by receipt of an electronic letter or paper letter | The proportion receiving an order to get a low-dose computed tomography (LDCT) lung cancer screen (LCS) scan by receipt of an electronic letter or paper letter | 12 months |
| The proportion completing a low-dose computed tomography (LDCT) lung cancer screen (LCS) scan by receipt of an electronic letter or paper letter | The proportion completing a low-dose computed tomography (LDCT) lung cancer screen (LCS) scan by receipt of an electronic letter or paper letter | 12 months |
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Inclusion Criteria: Qualifies for Lung Cancer Screening based on USPSTF criteria (aged 50-80, at least 20 pack years smoking history, currently smoke or quit in the last 15 years); have an upcoming, scheduled Primary Care visit in a KP clinic in the coming 7-14 days, have not completed a low-dose CT scan.
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Debra Ritzwoller, PhD | Kaiser Permanente | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Kaiser Permanente | Aurora | Colorado | 80011 | United States |
Quality Improvement study. No individual participant data will be available to other researchers.
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| ID | Term |
|---|---|
| D008175 | Lung Neoplasms |
| ID | Term |
|---|---|
| D012142 | Respiratory Tract Neoplasms |
| D013899 | Thoracic Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
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No masking involved. This is a quality improvement project where patients who have an upcoming Primary Care visit receive an electronic or paper letter notification that they qualify for lung cancer screening and that they should talk to their dr at the upcoming visit.
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| D008171 |
| Lung Diseases |
| D012140 | Respiratory Tract Diseases |