CPFF Robert Davidson Fellow Dr. Yassmin Behzadian is passionate about quality improvement (QI) initiatives, in which even small changes in medical procedures, treatments or systems can have a big impact on the quality of patient care and patient outcomes.
“QI is an area than has not been explored a great deal in ILD,” says Dr. Behzadian. “I’m so pleased to be working with the team at UHN to test a QI initiative looking to improve appropriate lung cancer screening referrals in patients with ILD.”
Addressing the Increased Risk of Lung Cancer in ILD Patient
Unfortunately, patients with ILD are at an increased risk of developing lung cancer. For example, approximately 10 to 20 per cent of patients with IPF will be affected by lung cancer. However, lung cancer screening is currently not routinely recommended for patients with ILD.
Given that smoking is a shared risk factor for lung cancer and for certain ILDs, many ILD patients qualify for lung cancer screening based on their smoking history. This is important as lung cancer screening in appropriate patients has been shown to reduce mortality.
Developing an EMR Tool to Enhance Screening Referrals
Treating both pulmonary fibrosis and lung cancer at the same time is complex and onerous, as well as taking an emotional toll on patients and their families. But early detection can make a difference in the successful treatment of lung cancer.
“Preventative health measures, like lung cancer screening, are not always top-of-mind when ILD specialists are meeting with their patients, who are often facing several other issues concerning their ILD symptoms, tests and treatment,” says Dr. Behzadian. “Adding this tool at the end of their notes, serves as a reminder to go through the screening criteria to initiate the referral to the lung cancer screening program.”
Preventative health measures, like lung cancer screening, are not always top-of-mind when ILD specialists are meeting with their patients, who are often facing several other issues concerning their ILD symptoms, tests and treatment.
– Dr. Behzadian
OLSP (as well as other provincial lung cancer screening programs) will then further assess whether the ILD patient would benefit from their program.
The team at TGH has recently implemented the tool and data will be collected on the number of appropriate referrals made to the lung screening program, and subsequent patient outcomes. “I know that I have already made a few referrals,” says Dr. Behzadian, “and that was not happening as regularly before.”
Potential Impact on ILD Treatment Guidelines
Depending on the analysis of the results from the ILD clinic at TGH, the new EMR tool may be added to ILD treatment guidelines for the province, and across the country, improving patient mortality.
Dr. Behzadian will complete her CPFF Robert Davidson Fellowship in September 2025 and intends to publish the results of this project. We will keep you posted.
“This fellowship has given me a wonderful opportunity – in time and resources – to learn to care for patients with ILD and to develop the skills to champion QI in the field, which is currently underutilized in ILD.
“I’m incredibly grateful to my colleagues, CPFF, and our patients for their support of me and this project. “
For more information about lung cancer and ILD, watch our educational video “Lung cancer in ILD patients: a serious growing problem” with UHN’s Dr. Shane Shapera.