Andrea Sipin-Baliwas Los Angeles Cancer Surveillance Program

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Presentation transcript:

Outpatient Clinic Reporting: Understanding the Landscape and Establishing Reporting Processes Andrea Sipin-Baliwas Los Angeles Cancer Surveillance Program University of Southern California NAACCR/IACR Meeting June 11, 2019 Vancouver, Canada

EVOLVING LANDSCAPE Delivery of cancer care is no longer exclusive to the hospital setting Organizations are exploring ancillary revenue streams Private practices are being acquired by larger entities Advocacy for improving access to care Cancer becomes a chronic disease

EVOLVING LANDSCAPE Other reasons contributing to migration of care to clinics: Availability of infusion pumps for chemotherapy Antiemetic medication Development of other targeted cancer therapies

EVOLVING LANDSCAPE Other entity in LAC with 10 outpatient clinics Multi-specialty Hematology/Oncology Dermatology/Internal Med Infusion Center Radiology/Surgery/Transplant

PURPOSE We aim to thoroughly evaluate the underreporting of cancer treatment data and incident cancer cases seen at free standing medical oncology clinics and establish reporting processes for this evolving landscape.

Disease Program (Diagnosis) BACKGROUND Partnered with City of Hope (COH) as they acquired new outpatient clinics in LAC Case year 2016  2216 patients 8 facilities in Los Angeles County (LAC) Full-service cancer centers Radiation facilities Medical oncology centers Last Name First Name Middle Name MRN DOB Radiation Biopsy Chemo Disease Program (Diagnosis) Facility Name Doe Jane   1234567 10/10/1965 20161114 NULL Bone Cancer Prime Facility A John 12345678 1/7/1953 20160802 0Hem Lymphoma Prime Facility B

METHODS Generate COH Clinical Case List Review cases in statewide database (In, Not In, Possible recurrence/mets) Send annotated case list to COH COH sends medical record files for cases as requested* 1) Add treatment or 2) Abstract new case Process in statewide database *Secure Web Portal for data exchange

RESULTS

CASE DISTRIBUTION – NEW CASES Missed cases for 15 different cancer sites Most common: 1) Prostate 2) Heme 3) Breast

CASE DISTRIBUTION – TREATMENT ONLY Missed treatment for 21 different cancer sites Most common: 1) Breast 2) Heme 3) Ovarian

EVOLVING LANDSCAPE MISSING TREATMENT

EVOLVING LANDSCAPE REPORTING PROCESS Created a new reporting source for the clinics COH is responsible for reporting cases starting with 2017 Additional staff for increasing efforts 10 FTE requested Registry will be the follow back contact Establish expected caseload over time Continue to open clinics and enter into partnerships

CONCLUSION Complete case capture is increasingly challenging Linkages are an important resource (i.e. SEER pharmacy linkage) Underreporting of Prostate cases Significant underreporting of Chemotherapy, Radiation Tx, Multiple Modalities Need to keep up with new reporting sources and establish reporting relationships State policies will help enforce reporting requirements Ensure complete electronic pathology reporting (AB 2325)

Co-Authors Dennis Deapen, DrPH Kelli Olsen, MS, CTR Camille Maristela THANK YOU Co-Authors Dennis Deapen, DrPH Kelli Olsen, MS, CTR Camille Maristela The collection of cancer incidence data used in this study was supported by the California Department of Public Health pursuant to California Health and Safety Code Section 103885; Centers for Disease Control and Prevention’s (CDC) National Program of Cancer Registries, under cooperative agreement 5NU58DP006344; the National Cancer Institute’s Surveillance, Epidemiology and End Results Program under contract HHSN261201800032I awarded to the University of California, San Francisco, contract HHSN261201800015I awarded to the University of Southern California, and contract HHSN261201800009I awarded to the Public Health Institute.  The ideas and opinions expressed herein are those of the author(s) and do not necessarily reflect the opinions of the State of California, Department of Public Health, the National Cancer Institute, and the Centers for Disease Control and Prevention or their Contractors and Subcontractors.