1 00:00:00,160 --> 00:00:02,319 This is Laura Dierda with the Becker's Healthcare 2 00:00:02,319 --> 00:00:04,559 podcast. I'm thrilled today to be joined by 3 00:00:04,559 --> 00:00:07,440 doctor Mark Meeker, vice president and chief medical 4 00:00:07,440 --> 00:00:10,740 officer of OSF Saint Mary Medical Center, OSF 5 00:00:10,800 --> 00:00:13,199 Volley Family Medical Center. Doctor Meeker, it's a 6 00:00:13,199 --> 00:00:14,980 pleasure to have you on the podcast today. 7 00:00:15,394 --> 00:00:17,015 Good morning. It's great to be here. 8 00:00:17,394 --> 00:00:18,675 Well, thank you for your time. And, you 9 00:00:18,675 --> 00:00:21,175 know, I'm excited for our conversation. We'll be 10 00:00:21,554 --> 00:00:24,214 talking about your first look lung cancer screening. 11 00:00:24,594 --> 00:00:26,355 Certainly, it'll be interesting to dig into that 12 00:00:26,355 --> 00:00:29,234 program and learn more, on such an important 13 00:00:29,234 --> 00:00:30,375 topic and especially, 14 00:00:31,079 --> 00:00:32,059 timely given, 15 00:00:32,520 --> 00:00:34,359 the challenges that I know so many people 16 00:00:34,359 --> 00:00:35,420 are having with, 17 00:00:35,880 --> 00:00:38,520 you know, cancer and getting screened and just 18 00:00:38,520 --> 00:00:40,679 making sure that they are able to have 19 00:00:40,679 --> 00:00:42,520 access to the care they need. So I 20 00:00:42,520 --> 00:00:44,445 think first and foremost, can you tell us 21 00:00:44,765 --> 00:00:46,924 what is the first look lung cancer screening 22 00:00:46,924 --> 00:00:48,545 and how does it benefit patients? 23 00:00:49,564 --> 00:00:52,125 Well, some people term these sort of new 24 00:00:52,125 --> 00:00:55,085 technologies liquid biopsies. And basically, what what the 25 00:00:55,085 --> 00:00:57,884 first look lung cancer test is is a 26 00:00:57,884 --> 00:00:58,704 blood test 27 00:00:59,380 --> 00:01:01,380 where and I can't describe all the chemistry 28 00:01:01,380 --> 00:01:02,979 to you in detail because it's been way 29 00:01:02,979 --> 00:01:04,420 too many years since I took that in 30 00:01:04,420 --> 00:01:06,840 college. But it's a blood test where, 31 00:01:07,219 --> 00:01:09,219 the lab techs look for certain strands of 32 00:01:09,219 --> 00:01:09,719 DNA, 33 00:01:10,579 --> 00:01:12,280 within within the plasma. 34 00:01:12,965 --> 00:01:14,164 Cancer cells have been, 35 00:01:14,724 --> 00:01:16,344 shown to shed a certain 36 00:01:16,724 --> 00:01:17,864 sequence of DNA, 37 00:01:18,724 --> 00:01:19,784 in in the bloodstream. 38 00:01:20,405 --> 00:01:21,784 So it's not a diagnostic 39 00:01:22,084 --> 00:01:24,564 test, but if we see these strands of 40 00:01:24,564 --> 00:01:26,344 of DNA fragments in the blood, 41 00:01:26,644 --> 00:01:28,024 it increases the 42 00:01:28,770 --> 00:01:30,629 risk category or the risk stratification 43 00:01:31,010 --> 00:01:34,150 of that patient having lung cancer quite substantially. 44 00:01:34,770 --> 00:01:37,170 So then we we have more evidence to 45 00:01:37,170 --> 00:01:39,010 convince them to go on to more specific 46 00:01:39,010 --> 00:01:39,510 screening. 47 00:01:40,545 --> 00:01:42,305 That's great to hear. And, you know, really, 48 00:01:42,305 --> 00:01:44,144 it makes a lot of sense and helpful 49 00:01:44,144 --> 00:01:44,965 to understand 50 00:01:45,344 --> 00:01:48,064 a little bit more background about, the screening 51 00:01:48,064 --> 00:01:48,965 and and technology. 52 00:01:49,584 --> 00:01:52,064 How has the initial phase been of offering 53 00:01:52,064 --> 00:01:53,745 these screenings, and and what are the next 54 00:01:53,745 --> 00:01:54,245 steps? 55 00:01:55,329 --> 00:01:57,409 We, you know, we've been looking for ways 56 00:01:57,409 --> 00:01:59,670 to to enhance our early detection program 57 00:02:00,369 --> 00:02:02,310 because in in lung cancer specifically, 58 00:02:03,729 --> 00:02:06,209 the stage at the time of diagnosis is 59 00:02:06,209 --> 00:02:08,069 critically important to five year survival. 60 00:02:08,775 --> 00:02:10,615 If if if you diagnose lung cancer at 61 00:02:10,615 --> 00:02:11,915 stage four, for example, 62 00:02:12,694 --> 00:02:14,855 the the average five year survival from the 63 00:02:14,855 --> 00:02:17,115 national database is around five percent. 64 00:02:17,574 --> 00:02:20,474 Now if you if you detect lung cancer 65 00:02:20,775 --> 00:02:22,395 early stage stage one, 66 00:02:22,775 --> 00:02:25,229 then the five year survival rate goes clear 67 00:02:25,229 --> 00:02:27,709 up to fifty five to ninety percent depending 68 00:02:27,709 --> 00:02:29,650 on the cell type and and other comorbidities. 69 00:02:30,509 --> 00:02:32,829 So that's more than a tenfold increase in 70 00:02:32,829 --> 00:02:33,729 five year survival 71 00:02:34,110 --> 00:02:36,509 stage one versus stage four. And even if 72 00:02:36,509 --> 00:02:37,969 they're just at stage two, 73 00:02:38,344 --> 00:02:40,044 which is still relatively early, 74 00:02:40,424 --> 00:02:42,424 that that survival at five year survival drops 75 00:02:42,424 --> 00:02:44,905 below fifty percent. So early detection in lung 76 00:02:44,905 --> 00:02:47,245 cancer is critically important to survival. 77 00:02:47,625 --> 00:02:49,224 So we were looking for ways through our 78 00:02:49,224 --> 00:02:51,465 innovation team at OSF HealthCare to find new 79 00:02:51,465 --> 00:02:53,485 technologies to help us with early detection, 80 00:02:54,180 --> 00:02:56,500 And and we've been working with with the 81 00:02:56,500 --> 00:02:57,479 first look company, 82 00:02:58,019 --> 00:02:58,919 on their technology, 83 00:02:59,300 --> 00:03:00,099 which is, 84 00:03:00,580 --> 00:03:03,639 evidence driven. They have excellent data published 85 00:03:04,019 --> 00:03:05,560 on their performance, 86 00:03:06,504 --> 00:03:08,344 and and we latched on to that and 87 00:03:08,344 --> 00:03:10,424 have been working with them to, implement this 88 00:03:10,424 --> 00:03:13,164 in OSF. So we started off like we 89 00:03:13,305 --> 00:03:15,485 often do with with a small pilot project 90 00:03:15,784 --> 00:03:17,564 in in in a handful of practices, 91 00:03:17,944 --> 00:03:19,305 you know, work out the kinks with the 92 00:03:19,305 --> 00:03:22,159 processes and whatnot. But it's gone so well, 93 00:03:22,159 --> 00:03:24,000 and we're so impressed with the results that 94 00:03:24,000 --> 00:03:26,560 we are gonna spread this across our entire 95 00:03:26,560 --> 00:03:28,900 primary care footprint, in the near future. 96 00:03:29,680 --> 00:03:31,360 Well, that's great to hear. You know? And 97 00:03:31,360 --> 00:03:31,860 certainly, 98 00:03:32,319 --> 00:03:33,759 helpful to understand how important that early detection 99 00:03:33,759 --> 00:03:34,500 is in 100 00:03:35,634 --> 00:03:37,955 terms of the outcomes and the survival rate 101 00:03:37,955 --> 00:03:38,775 and and whatnot, 102 00:03:39,235 --> 00:03:40,694 for lung cancer patients. 103 00:03:41,074 --> 00:03:42,854 Who is eligible for first look? 104 00:03:43,555 --> 00:03:46,034 The eligibility criteria, the exact same as low 105 00:03:46,034 --> 00:03:47,174 dose CT scanning. 106 00:03:47,740 --> 00:03:49,740 Low dose CT scan screening has been around 107 00:03:49,740 --> 00:03:51,759 for, I don't know, twelve or fifteen years. 108 00:03:52,300 --> 00:03:54,319 But when you look across the country, 109 00:03:55,180 --> 00:03:57,979 the average number of eligible patients to get 110 00:03:57,979 --> 00:03:59,919 low dose CT screening is 111 00:04:00,555 --> 00:04:02,655 just barely above single digits. 112 00:04:03,275 --> 00:04:04,955 Now when we first started looking at this 113 00:04:04,955 --> 00:04:06,875 at this about eighteen months ago in OSF, 114 00:04:06,875 --> 00:04:09,034 we are pleasantly surprised that our low dose 115 00:04:09,034 --> 00:04:11,915 CT screening rate was up around twenty five 116 00:04:11,915 --> 00:04:12,415 percent. 117 00:04:12,959 --> 00:04:15,039 And as soon as we started looking at 118 00:04:15,039 --> 00:04:17,379 this and talking about it with our group, 119 00:04:17,680 --> 00:04:19,600 we got up over thirty percent just by 120 00:04:19,600 --> 00:04:20,579 having the discussion. 121 00:04:21,279 --> 00:04:22,979 But the the screening criteria 122 00:04:23,360 --> 00:04:24,660 are a a patient, 123 00:04:25,444 --> 00:04:27,764 who is age 50 or older with a 124 00:04:27,764 --> 00:04:29,705 twenty pack year history of smoking, 125 00:04:30,564 --> 00:04:33,064 having not quit within the last fifteen years. 126 00:04:34,085 --> 00:04:36,085 So if they quit thirty years ago, they're 127 00:04:36,085 --> 00:04:38,165 not eligible. But if they quit fourteen years 128 00:04:38,165 --> 00:04:39,384 ago, they're still eligible. 129 00:04:39,800 --> 00:04:41,800 So it's fifty years old, twenty pack year 130 00:04:41,800 --> 00:04:42,300 history, 131 00:04:42,839 --> 00:04:45,100 having not quit more than fifteen years ago. 132 00:04:45,240 --> 00:04:46,920 So those people are eligible for a little 133 00:04:46,920 --> 00:04:49,420 CT scanning, and that's the exact same criteria 134 00:04:49,480 --> 00:04:52,360 for for first look. The advantage to first 135 00:04:52,360 --> 00:04:53,819 look is it's a blood test. 136 00:04:54,235 --> 00:04:55,435 So a lot of these patients are gonna 137 00:04:55,435 --> 00:04:57,595 be getting their blood test done anyway. So 138 00:04:57,595 --> 00:04:59,354 simply adding a blood test to their blood 139 00:04:59,354 --> 00:04:59,854 draw, 140 00:05:00,394 --> 00:05:02,394 it's not, you know, coming in for a 141 00:05:02,394 --> 00:05:04,474 CT scan and and taking another day out 142 00:05:04,474 --> 00:05:05,375 of work, etcetera. 143 00:05:05,995 --> 00:05:08,074 But what it does is it stratifies their 144 00:05:08,074 --> 00:05:08,574 risk. 145 00:05:09,610 --> 00:05:12,009 If if you take smokers that that meet 146 00:05:12,009 --> 00:05:14,970 the criteria for low dose CT screening and 147 00:05:14,970 --> 00:05:16,750 and screen a large population, 148 00:05:17,449 --> 00:05:19,389 you have to do somewhere around, 149 00:05:19,930 --> 00:05:22,089 if I remember right, it's, like, 380 150 00:05:22,089 --> 00:05:24,350 CT scans to find one one cancer. 151 00:05:25,175 --> 00:05:26,074 If they have 152 00:05:26,454 --> 00:05:29,254 a positive first look, that drops down to 153 00:05:29,254 --> 00:05:32,454 about one and eighty scans or 75 scans, 154 00:05:32,454 --> 00:05:33,514 somewhere in there. 155 00:05:33,974 --> 00:05:35,914 So you've really narrowed, 156 00:05:36,535 --> 00:05:37,274 the population 157 00:05:38,300 --> 00:05:40,800 down that really need that that that CT. 158 00:05:41,180 --> 00:05:43,100 If they have a positive first look, you 159 00:05:43,100 --> 00:05:44,620 know, they have a one in eighty or 160 00:05:44,620 --> 00:05:46,939 eighty five chance of having a lung active 161 00:05:46,939 --> 00:05:49,100 lung cancer instead of a one in, you 162 00:05:49,100 --> 00:05:50,860 know, two or three hundred chance of of 163 00:05:50,860 --> 00:05:52,834 having a lung cancer. So we can really 164 00:05:52,834 --> 00:05:55,074 streamline our focus on that, and it also 165 00:05:55,074 --> 00:05:55,894 gives the patient 166 00:05:56,435 --> 00:05:59,254 another incentive to proceed with with CT screening. 167 00:05:59,634 --> 00:06:01,074 And then on the CT screen, if you 168 00:06:01,074 --> 00:06:03,394 find a suspicious nodule, you know, we now 169 00:06:03,394 --> 00:06:04,615 have the robotic bronchoscopy, 170 00:06:05,240 --> 00:06:07,399 etcetera, to really be able to biopsy nodules 171 00:06:07,399 --> 00:06:08,600 that are much smaller than what we used 172 00:06:08,600 --> 00:06:10,279 to be able to do so you can 173 00:06:10,279 --> 00:06:12,680 really find those stage one cancers at a 174 00:06:12,680 --> 00:06:13,959 much higher rate than we used to be 175 00:06:13,959 --> 00:06:16,060 able to find them. And that has a 176 00:06:16,120 --> 00:06:16,620 magnificent 177 00:06:17,240 --> 00:06:17,740 substantial 178 00:06:18,439 --> 00:06:19,580 effect on survival. 179 00:06:20,115 --> 00:06:21,555 So and and that and that's the bottom 180 00:06:21,555 --> 00:06:22,055 line. 181 00:06:22,355 --> 00:06:25,394 So so this is pretty straightforward. There's some 182 00:06:25,394 --> 00:06:27,154 nuances to some of this and and how 183 00:06:27,154 --> 00:06:29,795 these workflows go, but it's pretty straightforward as 184 00:06:29,795 --> 00:06:31,475 to the impact that this might have on 185 00:06:31,475 --> 00:06:33,175 on our cancer survival rates. 186 00:06:34,180 --> 00:06:36,419 That's helpful to know. And really, truly, it 187 00:06:36,419 --> 00:06:38,519 seems like a a great option and opportunity, 188 00:06:39,379 --> 00:06:42,339 to improve that detection and survival rate long 189 00:06:42,339 --> 00:06:44,819 term. I'm curious, you know, to dig a 190 00:06:44,819 --> 00:06:47,185 little bit deeper here. What is First Look 191 00:06:47,185 --> 00:06:49,105 looking for in a blood test, and how 192 00:06:49,105 --> 00:06:51,125 does it promote them that early detection? 193 00:06:52,064 --> 00:06:53,904 Yeah. As I stated earlier and I and 194 00:06:53,904 --> 00:06:56,805 I'm not a a a lab table scientist. 195 00:06:57,105 --> 00:06:58,644 You know, I'm a clinical physician. 196 00:06:59,029 --> 00:07:01,509 But, basically, what what the first look does 197 00:07:01,509 --> 00:07:02,889 is is they use 198 00:07:03,430 --> 00:07:05,850 laboratory techniques to find DNA fragments 199 00:07:06,629 --> 00:07:07,610 within the bloodstream. 200 00:07:08,150 --> 00:07:10,730 And and there are certain sequences of DNA 201 00:07:11,504 --> 00:07:12,805 that that have been 202 00:07:13,264 --> 00:07:15,845 correlated with the presence of cancer cells, 203 00:07:16,225 --> 00:07:18,245 specifically, in this case, lung cancer cells. 204 00:07:18,705 --> 00:07:20,625 So as they screen the blood for these 205 00:07:20,625 --> 00:07:22,965 DNA fragments, if they find them, 206 00:07:23,665 --> 00:07:26,165 that puts the patient at higher risk 207 00:07:26,800 --> 00:07:28,660 of having an active lung cancer. 208 00:07:29,120 --> 00:07:30,420 It's not diagnostic 209 00:07:31,520 --> 00:07:33,120 if the first look it comes and it 210 00:07:33,120 --> 00:07:35,040 comes back as a binary result. It's either 211 00:07:35,040 --> 00:07:36,259 positive or it's negative. 212 00:07:36,560 --> 00:07:38,319 So it's easy to interpret. So if it 213 00:07:38,319 --> 00:07:40,420 comes back positive, it's not diagnostic. 214 00:07:41,504 --> 00:07:43,665 That doesn't mean that there's a lung cancer 215 00:07:43,665 --> 00:07:46,545 there, but it means they're at much higher 216 00:07:46,545 --> 00:07:49,264 risk of having a lung cancer there, which 217 00:07:49,264 --> 00:07:51,665 as I mentioned before is an incentive then 218 00:07:51,665 --> 00:07:53,845 to proceed with a low dose CT scanning 219 00:07:54,064 --> 00:07:56,324 and a biopsy if a nodule is found. 220 00:07:56,889 --> 00:07:59,550 So so it really streams line the risk, 221 00:07:59,850 --> 00:08:01,770 so there's a higher incentive and a higher 222 00:08:01,770 --> 00:08:04,250 return on the low dose CT scan. And 223 00:08:04,250 --> 00:08:05,470 with limited resources 224 00:08:06,089 --> 00:08:08,569 and and a value based care population health 225 00:08:08,569 --> 00:08:09,069 scenario, 226 00:08:09,449 --> 00:08:10,910 that becomes very important. 227 00:08:11,284 --> 00:08:12,745 You know? Instead of shotgunning 228 00:08:13,845 --> 00:08:15,305 scans across the spectrum, 229 00:08:15,845 --> 00:08:18,004 try and narrow the population down that really 230 00:08:18,004 --> 00:08:18,904 need the scan. 231 00:08:19,524 --> 00:08:21,844 And and the other the other nice feature 232 00:08:21,844 --> 00:08:23,204 of the first look that that I haven't 233 00:08:23,204 --> 00:08:25,144 mentioned is the negative predictive value. 234 00:08:26,019 --> 00:08:27,560 If the test is negative, 235 00:08:28,019 --> 00:08:30,500 there's less than something like a point zero 236 00:08:30,500 --> 00:08:32,500 four percent chance of a lung cancer being 237 00:08:32,500 --> 00:08:33,000 present. 238 00:08:33,379 --> 00:08:35,860 So a negative test really means you're okay 239 00:08:35,860 --> 00:08:38,019 right now. We'll screen you again in another 240 00:08:38,019 --> 00:08:40,214 year. So so the negative test has a 241 00:08:40,214 --> 00:08:41,434 lot of value too, 242 00:08:42,214 --> 00:08:43,815 because the risk of having an after count 243 00:08:43,894 --> 00:08:45,894 lung cancer with with a negative first look 244 00:08:45,894 --> 00:08:46,954 is very, very low. 245 00:08:47,815 --> 00:08:49,254 Got it. That makes a lot of sense. 246 00:08:49,254 --> 00:08:50,694 And, you know, it really seems like a 247 00:08:50,694 --> 00:08:52,534 smart way to go about it and just 248 00:08:52,534 --> 00:08:54,649 make sure you're covering all of your bases 249 00:08:54,649 --> 00:08:56,250 so that you can, you know, move forward 250 00:08:56,250 --> 00:08:57,309 with the right patients. 251 00:08:58,009 --> 00:09:00,649 What are the screening numbers for lung cancer, 252 00:09:00,649 --> 00:09:03,289 like, currently, and where would OSF's lung cancer 253 00:09:03,289 --> 00:09:03,789 program 254 00:09:04,330 --> 00:09:05,470 like them to be? 255 00:09:06,125 --> 00:09:07,725 Well, as I mentioned earlier, when we first 256 00:09:07,725 --> 00:09:09,804 started looking at this eighteen or twenty four 257 00:09:09,804 --> 00:09:12,044 months ago, our screening rate was around twenty 258 00:09:12,044 --> 00:09:13,884 three to twenty five percent, somewhere in there. 259 00:09:13,884 --> 00:09:15,964 I don't remember the exact number, which we 260 00:09:15,964 --> 00:09:18,204 were pleasantly surprised because at that time, the 261 00:09:18,204 --> 00:09:20,365 national average was, like, eight percent. I mean, 262 00:09:20,365 --> 00:09:21,090 it was terrible. 263 00:09:21,649 --> 00:09:24,610 And since we've implemented this, our our lung 264 00:09:24,610 --> 00:09:26,529 cancer screening rate, the last numbers that I 265 00:09:26,529 --> 00:09:27,730 saw, and I haven't seen them in a 266 00:09:27,730 --> 00:09:29,889 little while, but the last numbers I saw, 267 00:09:29,889 --> 00:09:32,710 I think we were approaching forty five percent. 268 00:09:33,605 --> 00:09:35,764 So that still means that we're missing over 269 00:09:35,764 --> 00:09:37,285 half of the patients that are eligible for 270 00:09:37,285 --> 00:09:39,605 screening. Our ultimate goal is to get this 271 00:09:39,605 --> 00:09:41,445 percent up to where we have, you know, 272 00:09:41,445 --> 00:09:43,845 breast cancer, lung cancer, and other, you know, 273 00:09:43,845 --> 00:09:45,865 routine screenings that we do every day. 274 00:09:46,230 --> 00:09:48,149 So we'd like to get this eventually up 275 00:09:48,149 --> 00:09:50,389 somewhere between, you know, the seventy, seventy five 276 00:09:50,389 --> 00:09:51,129 percent range. 277 00:09:51,509 --> 00:09:53,269 You never screen a hundred percent of eligible 278 00:09:53,269 --> 00:09:55,269 patients because some patients just don't they don't 279 00:09:55,269 --> 00:09:56,870 wanna be screened, you know, and you can't 280 00:09:56,870 --> 00:09:57,929 force them to be screened. 281 00:09:58,309 --> 00:09:59,990 So it's never going to be a hundred 282 00:09:59,990 --> 00:10:00,490 percent, 283 00:10:00,845 --> 00:10:02,605 but our ultimate goal is to really get 284 00:10:02,605 --> 00:10:03,825 this lung cancer detection 285 00:10:04,365 --> 00:10:06,605 through the a combination of first look and 286 00:10:06,605 --> 00:10:07,904 low dose CT scanning 287 00:10:08,365 --> 00:10:10,285 up to around, you know, seventy, seventy five 288 00:10:10,285 --> 00:10:11,825 percent. That's the ultimate goal. 289 00:10:12,605 --> 00:10:14,285 Wow. That would be a huge increase, 290 00:10:14,605 --> 00:10:16,570 from even where you were a few years 291 00:10:16,570 --> 00:10:19,210 ago, and it's really impressive to look ahead 292 00:10:19,210 --> 00:10:21,789 in that regard and in set big goals. 293 00:10:22,970 --> 00:10:25,049 I'm curious if someone has a smoking history 294 00:10:25,049 --> 00:10:26,889 and is interested in learning more about the 295 00:10:26,889 --> 00:10:28,485 screening, how can they do so? 296 00:10:29,044 --> 00:10:32,245 Well, we've really communicated this frequently and often 297 00:10:32,245 --> 00:10:34,664 and thoroughly through our throughout our medical group. 298 00:10:34,964 --> 00:10:36,964 So for our patients, the best thing to 299 00:10:36,964 --> 00:10:38,644 do is to talk to their primary care 300 00:10:38,644 --> 00:10:41,125 physician or their primary care APP about it 301 00:10:41,125 --> 00:10:43,784 because there's there's widespread knowledge of its availability. 302 00:10:44,559 --> 00:10:46,639 And then, of course, if someone is not 303 00:10:46,639 --> 00:10:48,800 an OSF patient, they can always just contact 304 00:10:48,800 --> 00:10:49,360 our our, 305 00:10:50,320 --> 00:10:52,080 health system through the website or through the 306 00:10:52,080 --> 00:10:53,920 phone number, and we'll get them connected with 307 00:10:53,920 --> 00:10:55,120 somebody who can help them out with the 308 00:10:55,120 --> 00:10:55,779 long screen. 309 00:10:56,654 --> 00:10:59,134 Got it. That's really helpful. And then finally, 310 00:10:59,134 --> 00:11:00,434 before we wrap up here, 311 00:11:00,815 --> 00:11:03,214 I'm curious, why did OSF choose to pursue 312 00:11:03,214 --> 00:11:03,954 this collaboration? 313 00:11:05,375 --> 00:11:07,855 Well, I remember it was probably ten years 314 00:11:07,855 --> 00:11:09,855 ago now. The president of OSF at the 315 00:11:09,855 --> 00:11:11,875 time was sister Diane Marie. 316 00:11:12,440 --> 00:11:14,600 And sister Diane Marie made a a comment 317 00:11:14,600 --> 00:11:16,299 at a leadership meeting. She said, 318 00:11:16,919 --> 00:11:19,399 we don't wanna be transformed in OSF health 319 00:11:19,399 --> 00:11:21,879 care. We wanna do the transformation of health 320 00:11:21,879 --> 00:11:24,220 care. We wanna be we wanna actively participate. 321 00:11:24,855 --> 00:11:27,195 So we've been pretty aggressive in in 322 00:11:27,735 --> 00:11:29,595 participating in value based care, 323 00:11:30,134 --> 00:11:31,894 and and part of that is develop the 324 00:11:31,894 --> 00:11:34,075 development of some service line structure, 325 00:11:34,695 --> 00:11:37,355 to really streamline our evidence based medicine dissemination 326 00:11:37,414 --> 00:11:38,794 within our our practices. 327 00:11:39,480 --> 00:11:42,039 And part of that service line development was 328 00:11:42,039 --> 00:11:43,500 an oncology service line 329 00:11:43,959 --> 00:11:46,139 with some young dynamic leadership. 330 00:11:47,480 --> 00:11:48,220 Ryan Lugenbeil, 331 00:11:48,519 --> 00:11:50,200 specifically, is is a young leader in our 332 00:11:50,200 --> 00:11:52,279 oncology service line who really wants us to 333 00:11:52,279 --> 00:11:52,779 become 334 00:11:53,105 --> 00:11:55,345 a leader in early detection. That's one of 335 00:11:55,345 --> 00:11:57,504 his personal goals is to get us to 336 00:11:57,504 --> 00:11:59,345 be a leader in early detection of cancer 337 00:11:59,345 --> 00:12:01,764 across the spectrum. And this lung cancer, 338 00:12:02,705 --> 00:12:03,205 program 339 00:12:03,585 --> 00:12:05,425 was almost a no brainer. When you when 340 00:12:05,425 --> 00:12:07,389 you look at the effects on survival and 341 00:12:07,389 --> 00:12:08,850 you look at this new technology 342 00:12:09,309 --> 00:12:11,070 and the data behind it and the evidence 343 00:12:11,070 --> 00:12:13,250 behind it and what's been published so far, 344 00:12:13,789 --> 00:12:15,250 we were just really excited. 345 00:12:15,629 --> 00:12:17,309 But the fact of the matter is a 346 00:12:17,309 --> 00:12:18,129 vast majority, 347 00:12:19,309 --> 00:12:21,835 nearly all, in fact, of true screening for 348 00:12:21,835 --> 00:12:23,774 these cancers happens in primary care. 349 00:12:24,154 --> 00:12:26,095 So it doesn't happen in in an oncology 350 00:12:26,154 --> 00:12:26,654 practice. 351 00:12:27,355 --> 00:12:28,095 And so, 352 00:12:28,555 --> 00:12:31,274 there's been huge collaboration between our primary care 353 00:12:31,274 --> 00:12:34,154 teams and our community medicine service line, which 354 00:12:34,154 --> 00:12:35,274 I was a former leader of, 355 00:12:36,120 --> 00:12:38,360 before I took this new position. And so 356 00:12:38,360 --> 00:12:40,759 I worked directly with Ryan Logan Buell and 357 00:12:40,759 --> 00:12:42,299 the oncology service line, 358 00:12:42,759 --> 00:12:44,139 doctor McGee, and others, 359 00:12:44,679 --> 00:12:46,360 to really forge ahead in the sort of 360 00:12:46,360 --> 00:12:48,519 detection program because primary care is where this 361 00:12:48,519 --> 00:12:49,340 actually happens. 362 00:12:50,455 --> 00:12:51,815 That's great to hear. And I I love 363 00:12:51,815 --> 00:12:54,695 that notion of doing the transformation instead of 364 00:12:54,695 --> 00:12:56,615 having it done to you. I I think 365 00:12:56,615 --> 00:12:59,915 it's, so important to have that kind of 366 00:12:59,975 --> 00:13:01,975 vision and foresight, and then the leadership team, 367 00:13:01,975 --> 00:13:03,750 as you mentioned, to carry that through, 368 00:13:04,149 --> 00:13:06,070 and truly make a difference for how you're 369 00:13:06,070 --> 00:13:09,429 redesigning the processes, workflows, and systems that help 370 00:13:09,429 --> 00:13:09,929 patients, 371 00:13:10,629 --> 00:13:12,950 achieve better outcomes and really leading to healthier 372 00:13:12,950 --> 00:13:13,450 communities. 373 00:13:13,830 --> 00:13:15,509 Doctor Meeker, thank you so much for joining 374 00:13:15,509 --> 00:13:17,315 us on our podcast today. This has been, 375 00:13:17,395 --> 00:13:19,475 you know, a really fascinating conversation, and I 376 00:13:19,475 --> 00:13:21,495 look forward to connecting with you again soon. 377 00:13:21,715 --> 00:13:23,475 Yeah. Appreciate it. Thank you very much for 378 00:13:23,475 --> 00:13:24,135 having us.