Many individuals referred for lung cancer screening may be ineligible. Overreliance on the EMR for identification of individuals at risk may lead to missed opportunities for appropriate lung cancer screening.

The current era of healthcare reform is driving a shift in priorities and pressures for delivery of high quality healthcare. With a surge in the need to efficiently meet patient care demands, and to accommodate the ever-evolving sophistication and modernization of information and communication technologies (ICT), it is an opportune time for innovative care delivery by telehealth. This article reviews the emergence of telehealth in America, describes modalities of telehealth services, and considers such factors as quality, means, and cost of delivery and need for telehealth services. Telehealth can increase access to primary and specialty care, and ensure high quality care at lower cost. The authors also discuss policy considerations related to telehealth, including the roles and contribution of nurses and future consideration for this state-of-the-art care model.

A nurse practitioner-led program of lung cancer screening, incidental pulmonary nodules, and tobacco-cessation services can provide additional revenue opportunities for a Thoracic Surgery and Interventional Pulmonology Division, as well as a health care system. The current national, median annual wage of a nurse practitioner is $98,190, and the cost associated directly to their salary (and benefits) may remain neutral or negative within certain programs. However, the larger economic benefit may be realized within the division and institution. This potential additional revenue appears related to evaluation of newly identified diseases and subsequent evaluations, procedures, and operations.

Asia (3.1 per 100,000), Northern Africa (2.8 per 100,000), and sub-Saharan Africa (2.2 per 100,000). The lowest estimated mortality rates were for Middle Africa (0.7 per 100,000). Conclusion: With current smoking patterns lung cancer will remain a major cause of death worldwide for several decades. Effective tobacco control policies must be implemented or enforced in order to further reduce smoking prevalence. Lung cancer mortality is likely to greatly increase in sub-Saharan Africa if appropriate tobacco control programs are not implemented. Although smoking is a highly preventable risk factor for lung cancer, exposure to other risk factors.

population was 66.2 (SD-6.7) years with 56% (14/25) being female and mean pack years of 50.8 (SD-19.5). Percutaneous needle aspiration (n¼11), endoscopic sampling (n¼10), and surgical biopsy/resection (n¼4) were performed as the first invasive diagnostic procedure. The outcomes of this initial sampling were cancer (n¼15), non-diagnostic (n¼7), benign (n¼2), and infection (n¼1). Three patients without an initial diagnosis underwent additional non-surgical biopsy attempts. Overall, surgical resection was performed in twelve patients (6 after previous diagnostic procedure, 2 after previous non-diagnostic procedure, and 4 as initial procedure). Final outcomes were cancer (n¼16), nondiagnostic procedure (n¼4), non-caseating granulomatous inflammation (n¼2), benign diagnosis after wedge resection (n¼2), and infection (n¼1). Conclusion: Within a nurse practitioner led, multidisciplinary, lung cancer screening program, a small proportion of patients undergo invasive diagnostic testing, despite a rather high prevalence of potentially actionable nodules. Within the NLST population receiving computed tomography, 6.1% underwent invasive testing with 43% undergoing testing that ultimately did not result in a cancer diagnosis. Within our multidisciplinary program, 4.8% underwent invasive testing with 36% undergoing testing not ultimately resulting in a cancer diagnosis. The utilization of multidisciplinary teams during the biopsy decision-making process may help decrease the number of non-diagnostic procedures. Further research is needed to help identify tools that improve patient selection for invasive testing in lung cancer screening programs.