Table 1.

LOTUS healthcare system characteristics and lung cancer screening programs.

HFHSKPCOKPHIMCHSUPHS
Healthcare system characteristics
 RegionMetropolitan DetroitDenver/Boulder Front RangeOahu, Hawaii Island, Maui, KauaiCentral, North Central, and Northwestern WisconsinPhiladelphia, Greater Delaware Valley
 State(s)MichiganColoradoHawaiiWisconsin, MichiganPennsylvania, New Jersey, Delaware
 Type of careMixed modelManaged careManaged careMixed modelMixed model
 NCI-designateda cancer centerNoNoNoNoYes
 Teaching intensityaMajorMinorMinorNonteachingMajor
 State-level smoking prevalenceb20.4%15.6%13.1%17.1%18.0%
 State-level lung cancer incidencec (per 100,000)65.643.346.260.0 (WI)64.7 (PA)
 State-level lung cancer–related mortalityd (per 100,000)48.530.231.643.0 (WI)45.2 (PA)
Lung cancer screening program
 Program launchApril 1, 2012January 1, 2014January 9, 2015April 1, 2014May 1, 2014
 Risk assessment and screening eligibilityCentralized assessmentCentralized assessmentProvider-driven assessmentProvider-driven assessmentProvider-driven assessment
Ordering provider documents eligibility at orderOrdering provider documents eligibility at orderNavigator confirms eligibility at orderOrdering provider documents eligibility at orderNavigator confirms eligibility at scheduling
 Tobacco cessation counselingPerformed by the ordering provider or navigatorPerformed by the ordering providerPerformed by the ordering provider or navigatorPerformed by the ordering providerPerformed by the ordering provider
 Shared decision makingCentralized SDM clinicPerformed by the ordering providerPerformed by navigatorPerformed by the ordering providerPerformed by the ordering provider
 LDCT orderPrimary care or specialty provider can place orderProvider referral to navigator, who places orderProvider referral to navigator, who places orderPrimary care or specialty provider can place orderPrimary care or specialty provider can place order
 Reporting resultsSent by navigator to patient and primary care providerSent by navigator to patient and primary care providerSent by navigator to patient and primary care providerSent to ordering provider to be discussed with patientSent to ordering provider to be discussed with patient
 Monitoring follow-up and treatmentOutreach and tracking by navigatorDecentralizedOutreach and tracking by navigatorOutreach and tracking by radiologyDecentralized
  • aAgency for Healthcare Research and Quality (AHRQ). Compendium of U.S. Health Systems, 2016. AHRQ Pub. No. 17–0046–1-EF: September 2017.

  • bCenters for Disease Control and Prevention. 2011–2016 State Tobacco Activities Tracking and Evaluation System. BRFSS Survey Data; 2017.

  • cU.S. Department of Health and Human Services, NIH, NCI. State Cancer Profiles, Incidence Rate Report by State, Lung and Bronchus, 2011–2015; 2018.

  • dU.S. Department of Health and Human Services, NIH, NCI. State Cancer Profiles, Death Rate Report by State, Lung and Bronchus, 2011–2015; 2018.