No abstract

It provides rapid documentation of telephone or other inquiries, registering, scheduling screening appointments, reporting results, diagnosis of lung cancer, and treatment, and archives all CT images for integrated access of image and patient information. It has been iteratively updated through user feedback, and supports medical reimbursement requirements and continuous quality improvement to minimize harms of lung screening across International ELCAP (I-ELCAP) sites. Result: More than 81,000 participants in 80 institutions worldwide have contributed their LDCT findings and images. The MS has provided efficient data collection for rigorous assessment of screening outcomes which has resulted in some 300 publications and abstracts for protocol updating, comparisons, and continuous quality improvement. Having anticipated "open science", the ELCAP MS has been translated into an open source MS that offers a reference standard for data elements (1,500 data fields, 267 required) for robust and efficient management of lung screening programs. This first open source translation has been adopted by the United States Veterans Administration (VA) and integrated into its VistA Electronic Healthcare System for deployment at 10 VA medical centers through a grant for VA Partnership to increase Access to Lung Screening (VA-PALS). The software is being certified by the Open Source Electronic Health Record Alliance (OSEHRA); source code is available on GitHub. Automated quantitative tools have been developed for identification and characterization of nodules, emphysema, major airways, calcification scoring of coronary arteries, aortic valve, thoracic aorta, breast tissue, liver, bone, and image quality. These tools are integrated into the ELCAP MS, and in the future will provide automatically-generated quantitative LDCT reports. Conclusion: The ELCAP MS and I-ELCAP protocol have helped define current global standards for lung screening. Its developers have now made the ELCAP MS publicly available through OSEHRA for support of lung screening programs of any scale throughout the world.