Utilization of Lung Cancer Registries in Learning Health Systems for Health Care Improvement

PURPOSE Lung cancer is the leading global cause of cancer mortality with substantial evidence of inequity, disparity in process and outcomes, and unwarranted clinical variation. Over the last decades, there has been major evolution and discovery in best evidence-based practice (EBP), enhancing diagnostics, management, and the delivery of precision medicine. However, questions remain about the completeness of translation of best EBP into delivered care. DESIGN Learning health systems (LHSs) have been defined as improvement environments where knowledge generation processes are embedded into daily clinical practice to continually improve the quality, safety, and outcomes of health care delivery. Lung cancer clinical quality registries (CQRs) provide a rigorous infrastructure supporting LHS function through the collection, analysis, and reporting of care process and outcome information delivered by health service organizations. CQRs measure the appropriateness and effectiveness of delivered care and report on the degree of best EBP delivery by stakeholder providers. The provision of risk-adjusted, benchmark reporting to stakeholders describes equity, disparity, and unwarranted clinical variation and is a fundamental driver of improvement in the safety and quality of care provided to consumers. RESULTS There is mounting international evidence of the positive impacts of CQR reporting on management processes, health care infrastructure, survival, quality improvement, and education within lung cancer communities. The use of implementation science approaches including the Knowledge to Action framework targets bridging the gaps between evidence-based knowledge and practice. CONCLUSION Registry evolution is exampled by the Danish Lung Cancer Registry, National Lung Cancer Audit (United Kingdom), Dutch Lung Cancer Audit, and Victorian Lung Cancer Registry (Australia), which identify innovation opportunities to close the evidence-practice gap, overcome service deficits, and lead to better decision making for health care improvement.