Alfaro Maria Katerina C, Shusted Christine S, Giamboy Teresa, Kane Gregory C, Evans Nathaniel R, Ruane Brooke M, Gatson-Anderson Eboni, Muse Emily, McMullen Mary, Kinsey Anne Marie, Murray Sandra, McNair Christopher, Barta Julie A
Office of Data Science, Sidney Kimmel Comprehensive Cancer Center, Thomas Jefferson University, Philadelphia, PA.
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Jane and Leonard Korman Respiratory Institute, Thomas Jefferson University, Philadelphia, PA.
JCO Clin Cancer Inform. 2025 Jun;9:e2400322. doi: 10.1200/CCI-24-00322. Epub 2025 Jun 25.
Lung cancer screening (LCS) is one of the most potentially impactful interventions of the past two decades for reducing lung cancer mortality. However, no current standard exists in the field for comprehensive data collection and tracking of LCS, despite availability of electronic health records (EHRs) and LCS management tools. In a widely expanding LCS program, harmonization of data becomes critical for decisions surrounding clinical care coordination and operational management.
This article summarizes the implementation of an integrated, digital framework within the Jefferson Health System using the Epic EHR and its customized SmartForms as well as Research Electronic Data Capture application. Leveraging these tools has allowed for standardized documentation across the LCS process continuum for each patient: LCS eligibility, shared decision making, low-dose computed tomography, and follow-up.
Since the initial rollout in October 2022, 11 program sites across four regional hubs have adopted this framework. A standardized process paired with interoperability between systems has resulted in a centralized data repository, increased communication and transparency within and between program sites, and decreased duplicative or manual processes across the entire LCS program.
The resultant digital framework is poised for scale-up and sustainment across the Jefferson Health System, and it can also be replicated across other LCS programs. Future iterations of the current work or adoption by other programs should take into account the complexities of the EHR itself and data provenance to ensure success. Active participation among stakeholders for synchronous coordination of building, implementing, and troubleshooting a comprehensive repository for LCS data can ultimately facilitate measurement of quality metrics and develop future research in early detection of lung cancer.
肺癌筛查（LCS）是过去二十年来最具潜在影响力的降低肺癌死亡率的干预措施之一。然而，尽管有电子健康记录（EHR）和LCS管理工具，但该领域目前尚无用于全面收集和跟踪LCS数据的标准。在一个广泛扩展的LCS项目中，数据的统一对于围绕临床护理协调和运营管理的决策至关重要。
本文总结了杰斐逊医疗系统内使用Epic EHR及其定制的智能表单以及研究电子数据采集应用程序实施的一个集成数字框架。利用这些工具能够对每位患者在LCS流程连续体中的情况进行标准化记录：LCS资格、共同决策、低剂量计算机断层扫描和随访。
自2022年10月首次推出以来，四个区域中心的11个项目站点采用了该框架。标准化流程与系统间的互操作性促成了一个集中式数据存储库，增强了项目站点内部及之间的沟通与透明度，并减少了整个LCS项目中的重复或人工流程。
由此产生的数字框架有望在杰斐逊医疗系统内扩大规模并持续应用，也可在其他LCS项目中复制。当前工作的未来迭代版本或其他项目采用该框架时，应考虑EHR本身的复杂性和数据来源，以确保成功。利益相关者积极参与同步协调构建、实施和排除LCS数据综合存储库的故障，最终有助于衡量质量指标，并开展肺癌早期检测的未来研究。
