Lung Screen Survey

Personal Information:

African American / Black
American Indian or Alaska Native
Hispanic or Latino
Other Race
White / Caucasian

Primary Care Physician:

Smoking Status Pack-Years

Have you had a prior CT of the chest in the last 12 months?

NCCN Lung Cancer Risk Factors for High Risk Qualification
Family history of lung cancer Personal history or chronic lung disease
Occupational exposure to lung carcinogens Radon exposure
Personal history of cancer (excluding known metastatic disease)

Yes No
Last treatment date:

Version Updates


• Fix issue with removing diagnoses • Fix for HL7 response and version information


• Update the HL7 process to check the project configuration on whether it should insert patients that do not exist. • Store MSH-10 with each test result into the diagnostic procedures. • Update Hl7 - OBR/OBX to show Observation title only once


• Create Journey Forward Role mappings • Fix issue where the Reset functionality on the ad hoc does not reset all the fields. • Fix issue where the clinical-trial Y/N filter is not remembered when saving an ad hoc report. • Update diagnostic procedures to store treatment facility. • Update adhoc report to be filterable by treatment facility. • Add Diagnosis Groups feature. • Fix issue with hl7 server sometimes not recognizing the end of a message • Add PDF attachments for patient diagnostic procedures • Make it possible to select multiple Resources for barrier interventions. • Add a new "Save and Continue" button for Barrier Resolution which will submit the form data and then reload the same page, instead of going back to the main Barriers page. • Updated Reports to display popup, and disable submit button while the report is running


• Fix providers' portal so that it can load diagnosis groups. • Add display for the filename of an attachment if one exists while editing documentation items • On patient-view, move status next to pencils in header • Update the Barrier Intervention tab to show the barrier in question • Fix drop-downs on Specialties/Diagnoses to be populated by id instead of title, and sort the list of specialties by name • Update the Journey Forward exporter to look for a matching diagnosis group if it doesn't find a match on the diagnosis


• Fix 500 error when updating a diagnosis group • Add diagnosis group column to Diagnoses admin page • Update Ad-Hoc Report form submission to only show pop-up when 'Submit' is pressed • Update Followup Cares admin page to have a multi-tab display


• Make sure the diagnosis group drop-downs in followup cares and surveillances only show active groups • Add messaging system • Trigger event alerts for navigator(s) when patient fills out new distress survey • Add a "select all" feature to all of the pop-ups on the ad-hoc reports page • Add medications and medical history to the patient portal


• Move "My Account" link next to Logout and make Event Alerts page and pop-ups be based on the navigator selected in the upper right corner • Fix Referral To and Referral From fields in ad-hoc reports


• Add attachment support to insurances • Fix HL7 server to be able to handle empty lines in messages • Preserve line breaks in PDF generated from HL7 messages • Send providers to the same place as navigators, with read-only access • Add ability for super-admins to export entire database to CSV's • 832 add Super-Admin setting to enable/disable messaging system