2015 Annual Report Lung Screening

Transcription

1 05 Annual Report Lung Screening Flaget Cancer Center Monte Martin, MD Joseph Shaughnessy, MD CANCER SERVICES PROGRAM

2 From the Director We are pleased to share with you the Lung Cancer Report for 05. With Kentucky leading the nation in lung cancer incidence and mortality, we are working hard to provide education and increase screening volumes in the counties served by Flaget Memorial Hospital. Through this valuable data about our lung cancer screening initiative, lung measure outcome data and diagnosis information for patients in these counties, we are able to glean a better understanding about opportunities to improve and close the health care gap in access to prevention and screening and reduce the rates of advanced lung cancer in our service area. Bobbi Harned, RN, BSN Director, Cancer Care at Flaget Memorial Hospital KentuckyOne Health Sue Downs, RN, MSN, CENP, FACHE President of Flaget Memorial Hospital

3 Overview KentuckyOne Health Cancer Care at Flaget Memorial Hospital has made foundational advances in cancer services over the past year bringing the highest quality care to patients in Nelson and surrounding counties. The partnership with the renowned James Graham Brown Cancer Center provides a broader network of expertise in the fight against cancer for local patients. KentuckyOne Health Cancer Care at Flaget is fully accredited by the American College of Surgeons in Radiation and the Commission on Cancer. Flaget has a board certified medical oncologist and radiation oncologist, lab services and PET CT on site. The cancer care team includes oncology certified nurses, oncology nurse navigator, research coordinator, social worker, dietician and support team members focused on patient centered care. Flaget Cancer Center s primary service area includes the following counties: Bullitt, Grayson, Hardin, Larue, Marion, Nelson and Washington. In 0, there were 33 lung cancers diagnosed for these counties. The data by stage and county is displayed in the corresponding Graph A. Lung cancer is the second leading cancer diagnosed and treated at Flaget. In 0, 8 of the 33 patients or 85% of the patients were diagnosed late stage. These statistics align with the lack of prevention and high smoking rates in the service area. Graph B displays lung stage by year (0-0) demonstrating year over year late stage diagnosis. Stage by County 0 Diagnosed and/or Treated Anderson Bullitt Grayson Jefferson Marion Nelson Washington Grand Total Stage Stage Stage Stage 3 8 Grand Total GRAPH A GRAPH B

4 Lung Cancer Screening KentuckyOne Health has offered lung cancer screening since September 0. As a result of the 00 National Lung Screening Trial in December 03, the United States Preventative Task Force announced a grade B recommendation for screening high risk individuals. Effective January, 05, under the Affordable Care Act, commercial insurances were required to begin covering lung cancer screening at 00%. On February 5, 05, Centers for Medicare and Medicaid Services (CMS) announced coverage for annual screening for lung cancer with low-dose computed tomography (LDCT) in adults who meet specific eligibility criteria. The Commission on Cancer requires a screening program be provided each year to target decreasing the number of patients with late stage disease. We focused on increasing lung cancer screening for the Flaget Memorial Hospital service area. Tobacco use and cancer prevention were identified as the highest community need for the service area. An analysis of 0 lung cancer screenings performed for residents in the service area revealed an opportunity to increase screening volumes in an effort to decrease late stage disease as discussed on the previous page. We followed the evidence based national guidelines required by CMS for lung screening criteria. Age pack year smoking history Quit smoking within 5 years For more information, see Program Assessment Worksheet on page 5. Through education and awareness community outreach events, marketing and primary care physician education and provision of criteria and order forms, we have increased screening volumes by over 500% in Lung Screening 05 Screening Gender Age Range Female Male Grand Total < Grand Total We screened 7 women and 6 men. One patient screened was outside the age range criteria. 3

5 Lung Cancer Screening Results 70% or 3 of the 33 patients screened did not require follow up. A nurse navigator is following those patients requiring follow up to ensure timely scheduling. Graph C displays the findings by age group. 67% or of the 33 patients screened originated in Bardstown (Nelson County). 33% or of the patients traveled outside of Nelson County. The majority of the patients had commercial insurance or Medicare. Graph D displays this information. Other points of interest: The most common incidental finding was newly diagnosed emphysema 79% or 6 of the 33 patients screened are current smokers Lung Cancer Screening Flaget Hospital 05 Lung Findings Age Group Follow Up Required No Follow Up Requied Grand Total < Grand Total GRAPH C 05 Lung Insurance City Commercial Medicare Medicaid Private Pay Grand Total BARDSTOWN 6 3 BLOOMFIELD 3 COXS CREEK LORETTA NEW HAVEN 3 SPRINGFIELD Grand Total GRAPH D BULLITT SPENCER ANDERSON HARDIN NELSON WASHINGTON LARUE MARION Please see the Program Assessment Worksheet on page 5 for more information.

6 Lung CT Cancer Screening Program Assessment and Compliance Worksheet Program Feature Shared Decision Making (SDM) and Counseling Visit (Required for Medicare patients) Lung CT Screening Order Component Practitioner Providing Visit Determination of Patient Eligibility According to Guidelines Initial Screening Follow Up Screening Orders for Both Initial and Annual Follow up Screens Practitioner Providing Visit A shared decision making and counseling visit has to be conducted by qualified practitioners: Physicians :PCP (recommended), Pulmonologist or other Specialists Qualified non-physician practitioner (PA, NP or CNS) Patient Eligibility for Lung CT Screening Guidelines Determined Age: (CMS Medicare Patients), Age (USPSTF - Commercial Patients) At least a 30 pack year smoking history Current smoker or have quit less than 5 years Symptoms Asymptomatic (no signs and symptoms of lung cancer) For Initial Screening: Requires a physician/qualified Non Physician Provider visit for counseling, shared decision making and written order. May be held same day as an E/M visit, but need to use modifier -5. Practitioner must determine patient eligibility as above Requires discussion of risks and benefits using decision tools Requires discussion of important of smoking cessation Requires counseling on the importance of adherence to annual LDCT lung cancer screening Writes appropriate order as described below For Follow up Screening: Only requires written order, however, if shared decision making visit is held, must meet all the same Shared Decision Making visit requirements as initial screening. Required Order Elements Beneficiary date of birth Actual pack-year smoking history (number) Current smoking status, and for former smokers, number of years since quitting Statement that patient has no signs or symptoms of lung cancer National Provider Identifier of ordering practitioner 5

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