COE Application Page – GO2 for Lung Cancer Healthcare Provider Portal

Welcome!

First, thank you so much for your patience. We know many of you have been waiting for the GO2 for Lung Cancer Centers of Excellence (COE) application process to reopen.

Currently, we are only accepting applications for our Screening and Cancer Care designations. In the future, we’ll be opening up additional designations and allowing limited numbers of COE members to apply for these new designations through a pilot program. We appreciate your interest in our program and we’d like to offer you the opportunity to participate in this pilot. If you’d like to participate, mark “yes” on the last question of the COE application form (below).

Thank you for your interest and partnership in raising the bar for high-quality lung cancer care.

GO2 for Lung Cancer, Excellence in Healthcare Delivery Team

COE Designations

COE Application Form

New COE Applicant Form

Applicant First Name *

Applicant Last Name *

Postnominals Postnominals

Professional Title *

Email *

Phone Number *

Extension

Facility Name *

Is your facility part of a Health System? *

Yes

Health System Name *

Please describe the facility's affiliation with the Health System *

This will populate the address fields below automatically

Enter Facility Address *

Enter Facility Address

Address Line 1

Address Line 2

City

State/Province

Zip/Postal

Main Website URL *

Facility Type * Facility Type

Setting * Setting

Service Location * Service Location

Select all Designations you wish to apply for

Screening

Cancer Care

Screening Qualifying Criteria Checklist

By selecting “Yes”, I attest that our program meets the selected designation criteria I am applying for on behalf of my institution. I attest that we will inform GO2 for Lung Cancer of any changes to our program. We will submit quality metrics data annually in support of the statements below.

If you answer “No” to any question, you will not be eligible to receive the designation. However, please continue with the application so that a team member can reach out to you to discuss qualification assistance.

Screen according to CMS, NCCN, USPSTF criteria; if your program screens patients outside these established criteria, please identify your process for identifying patients’ screening appropriateness and which additional risk factors are considered for screening eligibility. *

Yes

Comments

A patient-centered discussion (about the benefits and harms) occurs before or at the time of low dose CT screening - for every baseline screening at a minimum. *

Yes

Comments

Adherence to standards based on best-published practices for controlling screening quality, radiation dose and diagnostic procedures as outlined by American College of Radiology Practice Parameters. *

Yes

Comments

Utilize structured reporting and standardized follow-up and management decisions based on current, established screening classification systems and management algorithms (LungRADS, NCCN Clinical Guidelines, ELCAP). *

Yes

Comments

Consult with or refer to a lung cancer multidisciplinary* and cancer care team for the management of any concerning (thoracic or extra-thoracic) findings in the screening process. *

Yes

*Multidisciplinary is defined and must include at least 3 lung cancer disciplines from among the following: thoracic surgery, pulmonology, interventional pulmonology, interventional radiology, chest radiology, medical oncology, radiation oncology, pathology, advanced practice providers, navigator; if by referral, must explain the patient care referral pathway.

Comments

Integrate a standardized process within the screening workflow for patient and referring provider/care team communication on screening results and management plan. *

Yes

Comments

Provide cessation support to all screening patients with consistent integration of the Ask-Advise-Refer Process: Ask about current smoking status, Advise to quit, Provide or Refer for evidence-based cessation services as appropriate. *

Yes

Comments

Utilize a process for tracking, measuring, and reconciliation of annual and interval follow-up adherence in screening. *

Yes

Comments

Collect and review internal clinical outcomes in a quality improvement process. *

Yes

Comments

Qualification Status

Best Practice Recommendations

The criteria listed below are recommendations only. Your eligibility will not be affected by your answer to these questions.

Submission of LDCT screening data to a multi-site registry (e.g., ACR LCSR, IELCAP, or other). (This is not required for the designation.) *

Yes

Comments

Monitor for lung cancer stage shift among screen-detected lung cancers. *

Yes

Comments

Person Responsible for Screening Program

This may be you or someone else.

Name *

Title *

Email *

Phone *

IPN Qualifying Criteria Checklist (Check all that apply)

By selecting YES, I attest that our program meets the selected designation criteria I am indicating on behalf of my institution. I attest that we will inform GO2 for Lung Cancer of any changes to our program. We will submit quality metrics data annually that demonstrates we are aiming for quality care. (If you answer “no” to this question, you will not be eligible to be a designated Center of Excellence.

If you answer “no” to any question, you will not be eligible to be a designated Center of Excellence, however, your interest will be noted and a team member will be reaching out to help with qualification assistance.

Structured nodule reporting in place for standardized follow-up and management decisions based on established screening and nodule classification systems and management guidelines (Fleischner Criteria, LungRADS, ELCAP, NCCN). *

Yes

Consult with or refer to a lung cancer multidisciplinary and cancer care team for the management of any concerning findings. *

Yes

Commitment to a standardized process for communication with patients and their active care providers about test results and management plan. *

Yes

Ask about current smoking status, advise to quit, provide, or refer for cessation services. *

Yes

Adherence to standards based on published best practices for controlling screening quality, radiation dose, and diagnostic procedures as outlined by the American College of Radiology. *

Yes

Tracking, measuring, and reconciliation process for interval follow-up adherence for incidentally detected lung nodules based on patient risk for lung cancer and surveillance guidelines (Fleischner Criteria, LungRADS, ELCAP, NCCN). *

Yes

Internal clinical outcomes review and quality improvement process. *

Yes

Ask about current smoking status, and advise to quit, provide, or refer for cessation services (USPSTF, CMS). *

Yes

Best Practice Recommendation: Institutional workflows that capture (at all entry points into the health system) and refer incidental pulmonary nodules for management. *

Yes

Qualification Status

Smoking Cessation Qualifying Criteria Checklist (Check all that apply)

5 A’s (Ask, Advise, Assess, Assist, Arrange) are consistently integrated across the cancer care continuum in initial and follow-up visits. *

Yes

Evidence-based smoking cessation services are consistently integrated across the cancer care continuum in initial and follow-up visits. *

Yes

When clinically indicated and appropriate, FDA-approved pharmacotherapy (OTC and prescription) options are offered and prescribed to patients. *

Yes

Behavioral therapy modalities (in-person, telehealth, or telephonic) (individual counseling, motivational interviewing, group counseling, cognitive behavioral therapy) are offered and provided to patients as accepted. *

Yes

Best Practice Recommendation Actively engage in use of text messaging, app and/or web-based activities, and/or print materials for cessation work. *

Yes

Best Practice Recommendation Proactively address stigma and people-first communication to destigmatize lung cancer, build trust, and promote communication. *

Yes

Qualification Status

Cancer Care Qualifying Criteria Checklist

A patient-centered discussion about the potential benefits and harms of lung cancer treatment occurs at each point of the patient’s cancer care journey. *

Yes

Comments

Biomarker Testing:  Access to and compliance with guideline-directed testing for molecular and immune biomarkers with NGS technology in all patients with guideline-eligible tumors (when clinically appropriate). Using NGS results, consistently identify actionable mutations and eligibility for guideline-directed targeted therapies or immunotherapies (NCCN, ASCO, CAP). *

Yes

Comments

Medical Oncology: Compliance with practice standards for the diagnostic workup, staging, and medical oncology (disease specific) treatment of all lung cancer types based on evidence, expert consensus, and practice guidelines for cancer care and treatment (TNM Stage Classification for Lung Cancer, ACCP, NCCN, ASCO, ESMO, SITC). *

Yes

Comments

Radiation Oncology: Compliance with practice standards for the diagnostic workup, staging, and radiation treatment of all lung cancer types based on evidence, expert consensus, and practice guidelines for cancer care and treatment (TNM Stage Classification for Lung Cancer, ASTRO, NCCN, ESTRO). *

Yes

Comments

Thoracic Oncology: Compliance with practice standards for the diagnostic workup, staging, and surgical treatment of all lung cancer types based on evidence, expert consensus, and practice guidelines for cancer care and treatment (TNM Stage Classification for Lung Cancer, AATS, STS, SOS, ESSO, ACCP). *

Yes

Comments

Pathology: Comply with practice standards based on evidence, expert consensus, and practice guidelines for pathologic evaluation of malignancies (CAP, AMP ASCO, NCCN). *

Yes

Comments

Actively engage or have access to multidisciplinary expert input by way of tumor board or other team-based mechanism, including virtual. *

Yes

Comments

Commitment and care delivery mechanisms are in place that standardizes consistent communication with patients and their active care providers about test results, diagnostic workup, and management plan. *

Yes

Comments

Contribute to aggregated collection of relevant data and report to a cancer registry (hospital, central or state, or special purpose registry) (NCI, NPCR, SEER). *

Yes

Comments

Provide cessation support to all patients with consistent integration of the Ask-Advise-Refer Process: Ask about current smoking status, Advise to quit, Provide or Refer for evidence-based cessation services as appropriate. *

Yes

Comments

Qualification Status

Best Practice Recommendations

The criteria listed below are recommendations only. Your eligibility will not be affected by your answer to these questions.

Internal clinical outcomes review and quality improvement process in place.  *

Yes

Comments

At least one Thoracic Oncologist(s) is board certified thoracic or cardio-thoracic surgeons. *

Yes

Comments

Person Responsible for Cancer Care Program

This may be you or someone else.

Name *

Title *

Email *

Phone *

Biomarker Qualifying Criteria Checklist (Check all that apply)

Access to guideline-directed testing for molecular and immune biomarkers with NGS technology in all patients with guideline eligible tumors (when clinically appropriate) to determine eligibility for targeted therapies or immunotherapies. *

Yes

Biomarker and PD-L1 results are reviewed and discussed with patients once results are available. Discussion includes the clinical implications and therapeutic options based on these results. *

Yes

Biomarker and PD-L1 results are reviewed and discussed with patients once results are available. Discussion includes the clinical implications and therapeutic options based on these results. *

Yes

When appropriate, guideline directed PD-L1 and biomarker testing are integrated into treatment decisions before systemic therapy is initiated. *

Yes

In the setting of disease progression on FDA approved therapy, updated PD-L1 and biomarker testing is utilized to identify next therapeutic option. *

Yes

In the setting of disease progression, updated PD-L1 and biomarker testing is utilized to confirm need for clinical trial referral when FDA approved therapeutics are not an option. *

Yes

"Best Practice Recommendation Rapid on-site evaluation (ROSE), when available to increase diagnostic and molecular yield." *

Yes

"Best Practice Recommendation Utilization of liquid biopsy modalities in the setting of tissue insufficiency or unavailability and points of disease progression. " *

Yes

Qualification Status

MDT Qualifying Criteria Checklist (Check all that apply)

Regularly scheduled MDT (and more frequently if needed) meetings and case reviews. *

Yes

MDT comprised of cancer navigator and a minimum of 3 lung cancer disciplines (thoracic surgery, pulmonology, interventional pulmonology, interventional radiology, chest radiology, medical oncology, radiation oncology, pathology, advanced practice providers) *

Yes

Regularly scheduled Tumor Board attended by MDT that includes radiology and pathology and all advanced stage and complex lung cancer cases are reviewed. *

Yes

Patient-centered communication and coordination of information for expeditious clinical decision making and care. *

Yes

Designated navigator engaged in the clinical care continuum for all lung cancer screening and cancer patients. *

Yes

Best Practice Recommendation: Virtual MDT will be available/accessed in the absence of local MDT resources. *

Yes

Qualification Status

Patient Centric Research Qualifying Criteria Checklist (Check all that apply)

Internal policy and procedures and clinical pathways are in place to consistently access and query ClinicalTrials.gov or another commensurate tool on behalf of patients. *

Yes

Prompt referral to clinical trials when a disease has progressed and updated PD-L1 and biomarker testing confirm FDA-approved therapeutics are not an option. *

Yes

Best Practice Recommendation Submission of LDCT screening data to a multi-site registry (e.g., ACR LCSR, IELCAP, or other). *

Yes

"Best Practice Recommendation Cancer Care facility is engaged, equipped, and open to supporting patients in local clinical research trial enrollment" *

Yes

Best Practice Recommendation Cancer Care facility has a dedicated research team to support patient participation in clinical trials. *

Yes

Best Practice Recommendation Promote awareness of research participation impact among the patient population *

Yes

Qualification Status

Survivorship Qualifying Criteria Checklist (Check all that apply)

Lung cancer patient care is a shared and coordinated effort by oncology, primary care, and subspecialty providers (OCS, NCCN, COC). *

Yes

All lung cancer survivors should be assessed annually or more frequently to determine any needs and necessary interventions related to their cancer. (NCCN) *

Yes

Survivorship Program exists to meet the needs of lung cancer patients with curative intent (OCS, NCCN, COC). *

Yes

Screening for psychosocial and mental health needs of lung cancer survivors occurs regularly. Treatment and support are offered as needed (OCS, NCCN, COC). *

Yes

Ask about current smoking status, and advise to quit, provide, or refer for cessation services (USPSTF, CMS). *

Yes

Healthy lifestyle and behaviors, and preventive health measures are offered and provided to all lung cancer survivors (NCCN). *

Yes

Qualification Status

Would you like to participate in the Pilot Program when new designations become available?

Yes

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