Target Population
The 17 participating VA medical centers and their respective community-based outpatient clinics collectively care for over 700,000 Veterans and manage over 1,200 Veterans diagnosed with non-small cell lung cancer each year. The rate of stage III-IV disease at presentation is currently 45-65%.
Participating Facilities and Local Leadership
Each of the 17 VA-PALS sites has a physician site director, a dedicated thoracic radiologist, and an advanced practitioner lung screening navigator who together lead their local lung screening program. The 17 VA medical centers were selected based on their ability to support a robust lung screening program. Each was a level 1A VA facility with a high incidence of lung cancer but without a structured lung screening program. Each site was confirmed to provide high quality care across the lung cancer continuum, including advanced diagnostic services in pulmonology, radiology, and pathology; timely access to treatment by minimally invasive thoracic surgery, stereotactic radiotherapy, and medical oncology; an active smoking cessation program; and strong services for case management, social work, and mental health.
 |
| Participating VA Medical Centers | Site Directors | Specialty |
|---|---|---|
| Atlanta, GA * | Nick Maurice, MD | Pulmonology |
| Baltimore, MD | Janaki Deepak, MD | Pulmonology |
| Birmingham, AL * | Devika Das, MD | Medical Oncology |
| Chicago (Hines), IL ^ | Cheryl Czerlanis, MD | Medical Oncology |
| Cleveland, OH * | CJ Nock, MD | Medical Oncology |
| Columbus, OH | Paresh Timbadia, MD | Pulmonology |
| Denver, CO * | Robert Keith, MD | Pulmonology |
| Houston, TX *^ | Stephen Bujarski, MD | Pulmonology |
| Indianapolis, IN | Catherine Sears, MD | Pulmonology |
| Kansas City, MO | Andrea Covey, MD | Pulmonology |
| Louisville, KY* | William Wrightson, MD, FACS | Thoracic Surgery |
| Milwaukee, WI * | Andreea Anton, MD, FCCP | Pulmonology |
| Nashville, TN * | Jennifer Lewis, MD, MS, MPH Carol Callaway-Lane, DNP, ACNP-BC | Medical Oncology |
| Philadelphia, PA | Anil Vachani, MD, MS | Pulmonology |
| Phoenix, AZ | Samuel Aguayo, MD | Pulmonology |
| Prescott, AZ | James Johnson, MD | Internal Medicine |
| St. Louis, MO * | Andrea Loiselle, MD Jeffrey Chenoweth, MD | Pulmonology Radiology |
| Wichita, KS | Zubair Hassan, MD | Pulmonology |
VAPALS-ELCAP: Lung Screening Software
A software management system is a crucial component of any successful lung screening program. The VA-PALS software development team adapted the ELCAP software system for use within VA. This open-source adaptation of the ELCAP software is called the VAPALS-ELCAP Management System. Clinicians were involved at all stages of the collaborative development effort, providing feedback to ensure that the system is acceptable and feasible to the end users.
VAPALS-ELCAP facilitates national patient tracking, data aggregation, and prospective reporting. The system is scalable and can manage thousands of patients at each site who are undergoing lung cancer screening tests and procedures. As a prospective tracking and registry system, it facilitates quality improvement and research that investigates the process and outcomes of lung screening as it is implemented in the VA.
Because the VAPALS-ELCAP software system is VistA-based, it can be integrated with the VA’s electronic health record system to automate manual processes and reduce the need for double data entry. VAPALS-ELCAP is currently installed at the Phoenix VA Medical Center, where the lung screening team completed pilot testing in early 2021 and are now using the system to manage over 2,000 participants enrolled in their screening program. VAPALS-ELCAP is now available to all VA-PALS sites after migration to the VA Enterprise Cloud. The open source VAPALS-ELCAP software is being deployed throughout the VA and the world by I-ELCAP and Accumetra and numerous international collaborators.