Transcript Recommendation Means for Lung Screening Programs

Clinical Solutions for
Lung Cancer Screening (LCS)
Tom Tynes
Oncology Solutions
May 2015
Invivo Clinical Solutions
More than just boxes
Lung Cancer
Huge Problem, Fragmented Solutions
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Lung cancer is the number 1 cancer killer globally
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NLST demonstrated significant benefits, USPTF
recommended CT lung screening for long-term smokers
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‘Private’ cash-pay programs continue to expand
ACA requirements for private payors effective January 1, 2015
CMS reimbursement expected this year
Increase in hospitals/centers offering comprehensive lung
cancer programs to more effectively manage disease
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Life expectancy: 1.1 years after diagnosis
1.3M deaths/year worldwide; more than breast, colon, prostate,
pancreatic cancers combined
US: 160,000 deaths and 220,000 new cases/year
Emerging Markets burden even greater (China: 390,000 deaths and
490,000 new cases /year)
Screening, diagnostics, staging, multi-modality therapy (surgery, radiation
oncology, interventional therapy)
Benefits: improved survival, reduced long tern costs (high cost to treat
advanced disease)
Early diagnosis, accurate staging and timely treatment is
critical to better clinical outcome
65-70% Stage III or IV
Only 15%
will survive
5 years
Stage
0, I, & II
Lung Cancer Screening (LCS) Program
Extensive product & service offering for
successful implementation of a comprehensive
CT lung screening program throughout the
continuum of patient care
CT Lung Cancer Screening (LCS) Solution
Intelligent Integration throughout the Continuum of Patient Care
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Education and awareness programs for
physicians and at-risk patients
Local connections to patient advocacy groups
Assistance with reimbursement landscape
Marketing and public relations materials
Consultative
Services
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Structured online education
courses
Measured performance against
large clinical database
Helps ensure and document
proficiency
Education resources for new
physicians
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Education
Resources
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Computer-Aided
Detection
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Patient & Data
Management
Auto-detection of suspicious nodules
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Second reader for added confidence
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Workflow integrated
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Proven clinical performance
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Standard clinical protocols
(ACR Lung-RADS)
Automated, real-time 360° patient
status
Integrated IT interfaces (HIS, RIS,
PACS, EMR)
Reminder letters & program KPIs
Radiology
Workflow
Vendor-neutral chest CT review
Automated temporal comparison
Integrated Lung-RADS reporting
Results synced with patient manager
CT Lung Cancer Screening Reimbursement
A brief, recent history
June, 2011 NLST
releases initial
findings for CT lung
cancer screening for
high-risk individuals
2011
June, 2013 USPSTF
releases draft
recommendation
February, 2015 CMS issues a final national
coverage determination that provides for
Medicare coverage of Screening for Lung
Cancer with Low Dose Computed
Tomography (LDCT)
December, 2013 USPSTF
gives low-dose CT lung
cancer screening “B”
recommendation
2013
2014
2015
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April, 2014 MEDCAC
recommends against Medicare
coverage for lung screening
What USPSTF “B” Recommendation Means for Lung Screening Programs
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A grade “B” by the USPSTF means that the USPSTF recommends the service and that
there is high certainty that the net benefit is moderate or there is moderate certainty
that the net benefit is moderate to substantial
The Affordable Care Act requires that all new private health insurance plans cover all
preventative services that are rated at a grade “B” or higher by the USPSTF
Source: "Screening for Lung Cancer, U.S. Preventative Services Task Force
Recommendation Statement,” USPSTF Final Recommendation
Statement, Dec. 2013; Oncology Roundtable interviews and analysis
CMS Lung Cancer Decision Memo
Participants
Age: 55 – 77
30 Pack-years smoking and less than 15 years since quitting
No signs or symptoms of lung cancer
Marketing Services
Primary Care Physician
Shared Decision Making Visit – Benefits/Harms of Screening,
Follow-up diagnostics tests, over-diagnosis, FP rate, radiation exposure.
Counseling on adherence to the screening program and smoking cessation
Marketing Services
Radiologist
Board Certified, Training in diagnostic radiology and radiation safety
Supervision and interpretation of 300 chest CTs in past 3 years
CME to ACR standards
Radiology Imaging Facility
LDCT with CTDIvol < 3.0mGy for standard patients
Utilizes a standardized lung nodule classification and reporting system
Collects and submits data to a CMS-approved registry