New Jersey health system AtlantiCare's Lung Nodule Clinic used to be completely reliant on other healthcare providers to refer patients for evaluation.

THE PROBLEM

This meant the referring provider had to recognize the nodule was important and explain the importance to the patient, then make a timely referral to the appropriate clinic. Providers who do not often deal daily with lung nodules may not be aware of the resources that exist for a patient dealing with a lung nodule, or they may make the wrong decision regarding the best next step for the patient.

By reaching out to patients who are not already seeing a pulmonologist, then making sure they are aware of their pulmonary nodule and have a plan, AtlantiCare is able to capture lung cancer at its earliest stages and aim for a cure for that person.

PROPOSAL

How? AtlantiCare implemented an artificial intelligence-aided detection system, what it calls a virtual clinic. The AI system, from vendor Optellum, allows the Lung Nodule Clinic to identify patients in the community with concerning nodules and reach out to them directly to make sure they have someone capable of dealing with their lung nodule.

"The 'virtual clinic' can identify patients, help risk-stratify the nodule in question, and allow us to keep track of the plan for each patient," said Dr. Amit Borah, interventional pulmonologist at AtlantiCare. "Some patients do not need a biopsy, surgery or a treatment right away, but rather a repeat CT scan in a few weeks or months.

"The interventional pulmonology team quickly reaches out to the pulmonologists and primary care providers in the area and informs them we were using the technology to try to capture lung cancer at the earliest stage."

Dr. Amit Borah, AtlantiCare

"The virtual clinic offers us a way to keep track of each of these scans and make sure patients do not fall through the cracks."

MEETING THE CHALLENGE

As patients are identified by the artificial intelligence program, staff recognize a volume of concerning nodules that are out in the community.

"The interventional pulmonology team quickly reaches out to the pulmonologists and primary care providers in the area and informs them we were using the technology to try to capture lung cancer at the earliest stage," Borah explained.

The technology primarily is managed by Sarah Dean, NP, the thoracic surgery nurse practitioner. She enrolls patients in the virtual lung nodule clinic, reaches out to patients directly and coordinates care with already established providers.

RESULTS

"We have found an additional 80 patients with concerning lung nodules since starting the program," Borah reported. "This has led to an increase in biopsies performed as well as a possible decrease in how long it takes to go from nodule detection to diagnosis and treatment."

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