Partnering for Community Access: Mobile Lung Cancer Screening in Oklahoma
Oklahoma ranks near the bottom of states for lung cancer treatment and survival rates,1 and comes in 50th for screening of high-risk patients.2 According to Tracy Cothran, vice president of operations of the oncology division at the University of Oklahoma (OU) Health, improving these numbers requires addressing a lack of access to healthcare—and specifically imaging services—throughout many rural communities statewide.
“We are dedicated to making sure that every Oklahoman, despite where they live…has access to high quality care, and lung screening is a part of that,” Cothran says. “We screen about 2% of eligible Oklahomans—that is just scratching the surface of those who can benefit from the service.”
It is a mission of the academic health system—with the clinical mission at OU Health and the research and education missions within OU—to expand OU Health Stephenson Cancer Center’s research-driven, comprehensive cancer care to more communities in the state, particularly rural communities where care access can be nonexistent.
“Limited access to screening tools is definitely a barrier and a challenge,” Cothran continues, recognizing both the population’s higher-than-average risk for developing lung cancer and the state’s “imaging deserts." Oklahoma has an adult tobacco smoking rate of 15.6%3—above the national average—and a staggering 26% smoking rate for Non-Hispanic American Indians/Alaskan Natives.4 “We find lung cancer way too advanced today. We really need to…make sure that we are finding it when it’s small so it can be treated,” Cothran says.
An innovative solution
To meet the demands of its diverse, rural populations, OU Health partnered with Siemens Healthineers—the two announced a 10-year value partnership in December of 2023—and Lamboo Medical, a mobile medical accommodation manufacturer, on development of a unique, self-contained CT lung cancer screening vehicle to traverse the state. Applied Radiology sat down with representatives from the three organizations at RSNA 2024 to learn about how their collaboration will deliver services effectively to Oklahomans in need.
“Our vision is to bring quality healthcare, and make it available everywhere,” says Sander van de Walle, COO of Lamboo Medical. “The concept behind this self-contained mobile lung [unit] is about improving access to care, breaking down barriers, and taking the screening program to individual patients’ communities rather than them having to make the journey to the hospital environment,” explains Olivia Egan, director of CT Product Marketing at Siemens Healthineers. “We want to provide the imaging equipment and resources for a holistic approach to really break down those health inequalities, ensuring [that] no matter where you live, you have access to high-quality care,” Egan continues.
With philanthropic support from the Oklahoma Tobacco Settlement Endowment Trust (TSET), a longstanding partner of OU Health and OU, last year Siemens Healthineers, Lamboo Medical, and OU Health built the small-footprint, self-contained mobile lung cancer screening coach—part of OU Health Stephenson Cancer Center’s Oklahoma Mobile Lung Cancer Screening Action Network (Oklahoma LUNG SCAN)—that will travel across the state.
Self-contained design and capabilities
The new self-contained mobile unit has a 50 KVA generator mounted on the back, which meets all power requirements for the Siemens Healthineers SOMATOM go.Up CT scanner and environmental needs. Unlike cumbersome trailer units, it does not require a dedicated trailer pad, power hook-up, or portable generator, Egan says. The scanner boasts an all-in-one gantry design and no external generator cabinets, generating high-quality images for lung screening at an ultra-low dose via a unique tin filter technology, she says.
Egan reports the average duration is about 45 minutes from arrival to screening. “Everything is just drive up, so the set-up time is much shorter. Mobile CT imaging is not new, but what is unique…is it’s a self-contained unit,” she says. “There are no barriers to where we can take it.”
The small-footprint coach was designed with both the technologist and patient in mind, Egan explains. “When the screening program is in operation, a lead screen is deployed by the side of the gantry and in the back right corner…it becomes the CT control room. The technologist stays with the patient behind the lead screen during the entire examination.”
“We are helping support and empower all technologists, regardless of experience level, to be able to get high-quality CT imaging with ease, utilizing the guided intelligence of myExam Companion, which walks them through the CT scan, making sure that the reader has diagnostic confidence,” details Egan, noting the value of a simple, tablet-based mobile workflow amid staffing shortage challenges.
An optimized workflow enables continual patient throughput and real-time image submission to interpreting radiologists, enabling quicker turnaround time. “From a patient volume perspective, we’re … able to be highly efficient and see a great [number] of people in a given day, which is incredibly important,” says Cothran. “We have a lot of patients to serve.”
Solving access challenges
OU Health, which has brought mobile mammography to rural communities for more than three decades, has established a screening model where convenience and relationships are integral to success, says Cothran, so at-risk patients don’t have to make “hard choices.”
“When you have someone who’s struggling with food insecurity or money for transportation and gas, it is a large burden for them to leave a full day of work to get screening services. But when you take screening into the community and they can do it on a 15-minute break, that [burden] is so much smaller,” Cothran observes. “Compliance goes up and we’re able to successfully reach those that wouldn't ordinarily have those services provided.” “[With the coach’s flexibility to] be in one community one day, and another the next, you really have a great impact over the week’s time,” she continues.
OU Health seeks to make an impact beyond improving access, by establishing relationships in communities and helping educate residents about health risks and resources to support wellness on a broader scale. “Our vision is a very large mobile fleet comprised of mobile mammography, low-dose CT screening for lung cancer, research vans that …do PSAs [prostateprostate-specific antigen], [perform] different blood tests and fit testing, and [provide] a lot of education,” Cothran says, with focuses on topics like the impacts of tobacco use and obesity on health.
In collaboration with community health centers and hospitals—and continued partnership with global companies focused on innovative solutions—OU Health will highlight both prevention and education. “Our goal is to really shift the paradigm of cancer care,” Cothran concludes.
References
- Morin, SR, Sedani, AE, Sambo, AB, Campbell, JE, Doescher, MP. Cancer in Oklahoma Data Brief Series: Lung Cancer in Oklahoma. Community Outreach and Engagement, a program of OU Health Stephenson Cancer Center. August 2022 (2) 5. Accessed via https://www.ouhealth.com/documents/LungCancerOklahoma_DataBrief.pdf
- Oklahoma: How does your state compare? American Lung Association State of Lung Cancer 2024. Accessed via https://www.lung.org/research/state-of-lung-cancer/states/oklahoma#:~:text=Oklahoma%20ranked%2041st%20(out%20of,Oklahoma%20did%20not%20change%20significantly
- Oklahoma Highlights: How does your state compare? American Lung Association State of Lung Cancer 2024. Accessed via https://www.lung.org/research/sotc/state-grades/highlights/oklahoma
- Oklahoma Tobacco Use Reduction State Plan 2022-2027. Oklahoma State Department of Health Tobacco Control Program. Accessed via https://oklahoma.gov/content/dam/ok/en/health/health2/aem-documents/health-promotion/center-for-chronic-disease-prevention---health-promotion/tobacco-use-reduction-state-plan-2022.pdf
Kerri Reeves is a freelance writer from Ambler, PA, and a frequent Applied Radiology contributor.