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Assessing and Identifying Improvements for Lung Cancer Screening in a Rural Population: A Human-Centered Design and

Shaun A Golding¹, Rian M Hasson^2,3, Linda M Kinney¹

¹Center for Program Design and Evaluation, Geisel School of Medicine, Dartmouth College, Hanover, NH.

American Journal of Medical Quality : the Official Journal of the American College of Medical Quality

|September 1, 2023

Summary

Lung cancer screening is underutilized, especially in rural areas. This study identified barriers and developed interventions to improve lung cancer screening rates through enhanced patient awareness and physician identification.

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Area of Science:

Oncology
Public Health
Health Services Research

Background:

Lung cancer is the leading cause of cancer death in the US.
Lung cancer screening is significantly underutilized (<6% in 2021) compared to other cancer screenings.
Barriers to lung cancer screening in rural populations are not well understood.

Approach:

Conducted 26 stakeholder interviews (clinicians, staff, patients) and reviewed Electronic Health Record and billing data.
Utilized a human-centered design approach to pinpoint care process and EHR platform gaps.
Developed and deployed targeted communication interventions focused on patient awareness, physician identification, and patient management.

Key Points:

Stakeholder interviews and system reviews revealed critical gaps in lung cancer screening processes.
Interventions focused on enhancing patient awareness and improving physician-based patient identification.
A human-centered design approach facilitated the identification of actionable interventions within complex healthcare systems.

Conclusions:

Addressing systemic and process-level barriers is crucial for increasing lung cancer screening.
Human-centered design can identify effective interventions for complex healthcare systems.
Targeted communication strategies can improve lung cancer screening uptake.