Download The Central Cancer Registry As a Hub for Data Exchange

Integrating Central and Hospital
Registries To Improve Timeliness and
Data Quality
(The Central Cancer Registry as a Hub for Data Exchange)
David Rousseau, BS
Director, CIS
Hospital Association of Rhode Island
Rhode Island Cancer Registry
June 18, 2009
San Diego, CA
RICR supported by RI DoH and CDC/NPCR
Background
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The Rhode Island Department of Health
contracts the Hospital Association of
Rhode Island to maintain the statewide
cancer registry (RICR). The RICR is
funded by the Rhode Island Department
of Health and the National Program for
Cancer Registries of the Centers for
Disease Control and Prevention
Central Cancer Registries in General
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Collect data from hospitals and non
hospital sources
File statewide reports
Investigate areas of perceived elevation
Submit data to NAACCR & NPCR annually
Provide data to qualified researchers
Perform case finding and data quality
audits
Central Cancer Registries in General
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Central cancer registries have become the
primary source of training
Provide hospital administrators with data
to make strategic decisions
Provide registrars with technical assistance
Rhode Island Cancer Registry
Registry staff provide support to hospital
tumor registries and promote American
College of Surgeons approved cancer
programs in acute care hospitals
throughout the State.
Promoting Hospital Registries
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Provide hospital cancer registries with
diagnostic and treatment information on
shared cases when the information isn’t
available in the patient’s record so the CTR
can complete a hospital cancer registry
abstract
Provide follow-up information to hospitals
when traditional methods failed
Follow-up!
Follow-up on Demand
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Reporting hospitals were already providing RICR
with update information electronically monthly
RICR staff were already providing follow-up
information via telephone inquiry
Follow-up is a labor intensive activity that does
not require the skill set of CTR
Lends itself to automation
Follow-up benefits for hospitals and RICR
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Reduces CTR time spent on a clerical function
Improves timeliness
Hospital Follow-up Process
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Check hospital databases for recent admissions
Generate follow-up letters for physician offices
Generate follow-up letters for other hospitals
Fax letters
Generate letters to secondary sources
Call physician offices
Call RICR
Update hospital abstract
Follow-up on Demand
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RICR staff working with RMCDS developed the
follow-up on demand process
The hospital cancer registry creates a file of the
cases that are due to be followed in the coming
month that is sent electronically to RICR
RICR conducts a match for cases to be followed
after the monthly data submission is processed
Cases with more current follow-up date are
added to a file that is returned to the requesting
hospital for review
Follow-up Match
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Hospital code number assigned by DoH
Accession number
Sequence number
Medical record number
Follow-Up Report Layout
Required Fields
1. Pt_Accn_No (Accession Number)
2. Dg_Seq_no (Sequence Number)
3. Pt_Med_Rec_No (Medical Record
Number)
4. Pt_Last_Nm (Patient Last Name)
5. Pt_First_Nm (Patient First Name)
6. Dg_Init_Dx_Dt (Date Of Initial Dx)
7. Dg_Site (Primary Site)
8. Dg_Last_Fol_Dt (Date Of Last Follow-Up)
13
Final Report
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Accession Number
Chart
Last Name
First Name
Date of Diagnosis
Primary Site
Date Last Seen
Patient Status
Cancer Status
Death Certificate Number
14
Final Report Format
Cases where the RICR has a more current Date Last Scene
Accession #
Rec #
200000001-02
200100002-00
200200003-01
200300004-00
Lst Name First
12345
21450
99999
54321
Doe
Smith
Doe
Smith
Date of Dx
Site
DLS
Vstat
Jane
01/01/2000 C509 01/01/2009
John
01/01/2001 C349 02/01/2009
1
John 01/01/2002 C259 01/15/2009
0
Jane
01/03/2003 C509 12/15/2008
1
C DC #
1
1
2
1
1
15
Monthly Follow-up Results
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Monthly follow-up returns averaged 7.1%
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High of 8.6%
Low of 5.6%
Time Saving
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Hospitals in Rhode Island follow 49,520 cancers
in a given year.
Hospitals conduct follow-up on 4501 cancers on
average in a given year.
The RICR provides follow-up on 3515 cancers
statewide
The RICR provides 78% of an average hospital’s
follow-up burden in a given year.
Time Savings
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With hospital cancer registrars spending
less time on follow-up they will have more
time to spend on case finding, abstracting
and internal quality control projects.
The net result should be data that more
timely and of higher quality
Lost to Follow-up
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Hospital cancer registries consider patients
that have not been followed for 18 months
to be lost to follow-up and active follow-up
is ended
Since these cases can impact the CoC
approval process we decided to include a
lost to follow-up search
Lost to Follow-up Results
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Lost to follow-up search found an average
12.7%
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High of 18.1%
Low of 8.2%
Additional Cooperative Venture
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The RICR sponsored a statewide meeting
to introduce the new METRIQ operating
system that was presented by the Elekta
Northeast Registry Supervisor.
Future Plans
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RICR staff are working with RMCDS to
develop a process that allows hospitals to
share diagnostic and treatment data on
shared cases using the RICR as a hub for
data exchange
Work with hospital cancer registry staff to
promote greater use of existing software
capabilities
Special Thanks
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Tara Szymanski, CTR
Rhode Island Hospital & RICR
Larry Derrick
Rocky Mountain Cancer Data Systems
Rhode Island Cancer Registry Community