Overview
To evaluate the real-world effectiveness and implementation strategies for mPATH-Lung, investigators propose a pragmatic, randomized controlled trial across an academic Learning Health System. The trial will contrast several approaches to participant outreach and will specifically target engaging fully powered cohorts of racial/ethnic minorities and rural residents.
Description
Primary Objective: Evaluate the real-world effectiveness of mPATH-Lung in increasing lung cancer screening rates across diverse populations.
Secondary Objectives
- Compare the differential effectiveness of three outreach strategies for engaging participants with mPATH-Lung across vulnerable rural or ethnic/racial minority population subgroups.
- Estimate the additional revenue generated by mPATH-Lung through increased screening and downstream care.
- Evaluate the potential for over-screening and the impact of applying HEDIS-based exclusion criteria
Eligibility
Inclusion Criteria:
Eligible patients will:
- Meet the Medicare criteria for lung cancer screening, as updated in February 2022:
- Age 50 - 77 years
- Smoked at least 20 pack years
- Current smoker or quit smoking within the past 15 years
- Be established with a primary care provider within the Atrium Health Wake Forest Baptist health network (defined as having completed at least 1 primary care appointment in the past 6 months or have completed at least 2 primary care appointments within the past 18 months or being scheduled to see a health network primary care provider within the next 30 days).
- Have a patient portal account or cellphone number listed in the electronic health record
- Have a North Carolina address listed in the electronic health record
Exclusion Criteria:
The following patients will be excluded:
- Patients flagged as needing a language interpreter in the electronic health record for any language other than Spanish (electronic messages and intervention are deliverable in English or Spanish only)
- Those for whom lung cancer screening would be or may be inappropriate:
electronic health record Prior history of lung cancer electronic health record Chest CT within the last 12 months electronic health record Those meeting the HEDIS COL-E measure exclusion criteria based on significant comorbidities and/or frailty.
