Electronic Cancer Reporting: Taking Cancer Reporting to the Next Level
Mark J Tuthill ; Henry Ford Hospital;
Content:
Federal and State regulations require centers diagnosing cancer to report results to designated local/regional cancer registry. For our health System, the local registry is at the Henry Ford Hospital (HFH) and the Regional registry is the Detroit Metropolitan Cancer Surveillance System at the Karmanos Cancer Center. Traditionally, data originating from the Department of Pathology and Laboratory Medicine underwent a multistep process to be made suitable for transfer to the registries.
Technology:
LIS: Sunquest CoPathPlus v2.5 " (Sunquest, Tucson, AZ) Servers: Windows Server 2003 " (Microsoft, Redmond WA) New Application: E-Path " (AIM Inc, Toronto, Canada)
Design:
Pre- E-Path Process: Data was transmitted in the form of paper copies of the final pathology reports for all patients to the HFH registry at the Medical Records Department of the Henry Ford Hospital. Each report was manually examined to identify cases that qualified for reporting to the registry. Cases were coded manually for topography and morphology and this data was entered into the registry database. The paper reports of cases that qualified for reporting were then transferred to the regional registry. At the Regional registry, the registrar would extract similar data from the paper pathology report. Once the electronic data from HFH registry reached the regional registry, it was manually consolidated and verified against that already in their database. New Design & Implementation: In the new paperless, electronic system, after the report is finalized in CoPathPlus, the E-Path software receives HL7 data from CoPathPlus". E-Path processes each report to identify key terms that indicative of cancer, then formats and transmits the selected positive cases to the HFH and Regional registries real-time over a fire-walled, secure VPN connection. Interface testing was performed ensuring no loss or distortion of data between all the provider and receiver units. Quality control measures included manual comparison of the reports transmitted online with the simultaneous facsimile transmission of the same case to ensure reliability of transfer of identification data and appropriate content.
Results:
Results: Software calibration was performed to achieve 100% sensitivity and 98.9% specificity in case finding. The interface has been implemented and deployed in production since February 2007. This has resulted in elimination of paper reporting saving money and time. Further, as only required cases are transmitted, HIPAA compliance has been achieved. The time for transmission and receipt of cases has been markedly reduced from weeks to minutes.
Conclusion:
Conclusions: Implementation of IT solutions leads to savings of resources and help achieve better regulatory compliance. Deployment of the electronic reporting system (E-Path ") has resulted in saving time, material resources such as paper and printing supplies, increased regulatory compliance and improved the quality of cancer registry reporting. Since the system-wide LIS functions from a common database server, designing the interface once has made the same service available to other hospitals in the system.
