Implementation of an Electronic Medical Record Alert Significantly Increases Lung Cancer Screening Uptake

IF 4.3 3区 材料科学 Q1 ENGINEERING, ELECTRICAL & ELECTRONIC
Ju Ae Park , Sriya Yalamanchili , Zeliene Brown , Andrew Myers , Michael J. Weyant , Amit K. Mahajan , Christopher Patrick Connolly , Kei Suzuki
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Abstract

Introduction

Lung cancer survival is significantly improved with early detection. However, lung cancer screening (LCS) uptake remains low despite national recommendations. Our aim was to determine whether implementation of an electronic medical record (EMR) alert and order set would increase LCS uptake.

Study design

A query of current and former smokers identified 62,630 patients aged 50 and above in the primary care setting between January 1, 2021 and May 5, 2022. We randomly reviewed 3704 charts for LCS eligibility and recorded who received LCS in the form of low-dose computed tomography amongst the eligible patients. We collected demographic information including gender, race, primary language, ethnicity, zip code, and insurance. Data analysis was performed utilizing 2-proportional z tests.

Results

We identified 461 patients who were LCS eligible. Our overall LCS uptake was 19.9% (92/461). Three-time frames were analyzed: (1) prior to EMR alert implementation, (2) after implementation of EMR alert (January 7, 2021), and (3) after implementation of EMR alert and order set (March 3, 2021). Screening uptake was significantly improved with initiation of EMR alert (1/46 [2.2%] to 23/109 [21.1%]; P = .003). LCS uptake remained similarly high after subsequent order set implementation (23/109 [21.1%] and 68/306 [22.2%]; P = .72). Amongst the different demographics, age was significantly associated with screening uptake, with age ≥65 demonstrating statistically significant increased rates of screening (15.6% [41/263] for <65 vs 25.8% [51/198] for ≥65; P = .007).

Conclusion

Implementation of EMR alerts significantly improves LCS uptake in the primary care setting. Such efforts should be considered in other hospital settings to improve LCS uptake.
电子病历警报的实施显著提高了肺癌筛查率。
导言早期发现肺癌可大大提高存活率。然而,尽管国家提出了建议,但肺癌筛查(LCS)的接受率仍然很低。我们的目的是确定电子病历(EMR)警报和订单集的实施是否会提高肺癌筛查率:研究设计:2021 年 1 月 1 日至 2022 年 5 月 5 日期间,通过对目前和以前的吸烟者进行查询,确定了 62,630 名年龄在 50 岁及以上的初级保健患者。我们随机审查了 3704 份病历,以确定是否符合接受 LCS 的条件,并记录了符合条件的患者中哪些人接受了低剂量计算机断层扫描形式的 LCS。我们收集了人口统计学信息,包括性别、种族、主要语言、民族、邮编和保险。数据分析采用 2 比例 z 检验:我们确定了 461 名符合 LCS 条件的患者。我们的总体 LCS 使用率为 19.9%(92/461)。我们对三个时间框架进行了分析:(1) EMR 警报实施前;(2) EMR 警报实施后(2021 年 1 月 7 日);(3) EMR 警报和订单集实施后(2021 年 3 月 3 日)。随着 EMR 警报的启动,筛查接受率明显提高(从 1/46 [2.2%] 到 23/109 [21.1%];P = .003)。在随后的订单集实施后,LCS 使用率同样保持较高水平(23/109 [21.1%] 和 68/306 [22.2%];P = .72)。在不同的人口统计学特征中,年龄与筛查率显著相关,年龄≥65 岁的筛查率有统计学意义的显著增加(15.6% [41/263] ,年龄≥65 岁的筛查率有统计学意义的显著增加(15.6% [41/263] ,年龄≥65 岁的筛查率有统计学意义的显著增加):在基层医疗机构实施电子病历警报可明显提高 LCS 的接受率。在其他医院环境中也应考虑开展此类工作,以提高 LCS 使用率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
7.20
自引率
4.30%
发文量
567
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