Web Plus Overview Division of Cancer Prevention and Control National Center for Chronic Disease Prevention and Health Promotion CDC Registry Plus Training May, 2012 Kathleen Thoburn and Sanjeev Baral CDC/NPCR Contractors Joseph D. Rogers Team Lead, Data Analysis and Support Team, NPCR, CDC

CDC–NPCR Web Plus Contacts Kathleen K. Thoburn, CDC/NPCR Contractor Sanjeev R. Baral, CDC/NPCR Contractor

General Overview Web-based application used to collect cancer data securely over the public Internet Ideal for use by central registries for reporting from physicians’ offices, low volume facilities, hospital and non-hospital reporting sources, and for follow-back efforts Allows data sets and edit sets to be customized by central registry

General Overview Data entered are validated by the CDC EDITS Engine running on a web server Records are saved in a database at the hosting central registry and cases entered by one facility or office are not visible to other facilities Hosted on a secure web server that has a digital certificate installed – communication between client and server is encrypted with Secure Socket Layer (SSL) technology

Web Plus System Architecture Internet Information Services Hosting Web Plus External Firewall Internal Firewall SQL Server Web Plus User Demilitarized zone Web Plus Database

Web Plus Security Form-based authentication (UserID, password) Role-based access to functions User actions are logged and are available for audit Facilities can only view their own abstracts System security is the responsibility of the central registry: – securing network infrastructure – configuring web server for security – installing digital certificates on web server and optionally on client’s for SSL encryption/server validation – fault tolerance, backup plans, etc.

Web Plus Main Functions Online Abstraction File Uploading/Downloading Data Editing DCO and Path Lab Follow-back Supporting Functions – – Reports

Capabilities - Abstraction Lookup assisted data entry with advanced search feature Link for each data item to the NAACCR Standards for Cancer Registries Volume II: Data Standards and Data Dictionary for information about the data item Code selection from drop-down lists Calculation of Age at Diagnosis Supports Collaborative Staging calculation

Display types are configured by central registry – Ordered subsets of standard NAACCR and local data items collected by the central registry – Critical fields Allows assignment of different display types and edits for different facilities and types of cancer reporters Abstracts are entered and edited using the display type and edit set assigned to the facility Edits are re-run each time an abstract is saved, and remaining errors displayed for correction Capabilities – Data Editing

Display Type Section Headers Critical Field Data Item Labels Link to NAACCR Standards Drop Down List Special Lookup

Role-based access to functions – File Uploader – Facility Abstractor – Local Administrator – Central Registry Abstractor/Reviewer – Central Registry Administrator – Follow-back Supervisor – Follow-back Monitor – File Upload Supervisor Web Plus Roles

– Facilities can submit bundles of abstracts in the NAACCR format – Files run through Edits validation upon submission – Error report available after upload – Can also download files posted by the central registry File Uploader

Supports automated rule for file acceptance – Accept if less than n% of records have errors Administrator can override automated rules – Accept or Reject Option for offline, batch running of edits on large files and under heavy load conditions available File Uploader

Central Registry Administrator Manages facilities and users at both central registry and facilities Configures display types, edit sets and system preferences Manages assignment of abstracts to central registry staff Exports data and views reports

Central Registry Administrator Generating Display Types

Local Administrator Manages local users of a facility Views reports

Facility Abstractor Enters abstracts and corrects errors until abstract is complete (no errors remain) Releases abstracts to central registry Views reports

Central Registry Abstractor Reviews abstracts released to the central registry, verifying submitted codes with submitted text Re-releases abstracts for export into the central registry Enters new abstracts

Web Plus Data Flow Facility 1. Create abstract 2. Update data 3. Correct errors 4. Complete abstract 5. Release abstract Facility Abstractor

Web Plus Data Flow Central Registry 1. Assign released abstract 5. Correct errors 6. Complete abstract 7. Release abstract 4. Visually review/up date 8. Export abstract Administrator CCR Abstractor/ Reviewer 3. Open Abstract for Review 2. Accept into Work Queue CCR Abstractor/ Reviewer

Facility Online Abstracting

Facility Completed Abstract Release

Administrator Assign Released Abstract

CCR Abstractor/Reviewer Accept Abstract

CCR Abstractor/Reviewer Find/Open Abstract

CCR Abstractor/Reviewer Re-release Abstract

Web Plus Administrator – Exporting Released Abstracts

Facilities can submit bundles of abstracts in the NAACCR format, or other files in any format NAACCR files run through Edits validation upon submission – Error report available after upload Supports automated rule for file acceptance – Accept if less than n% of records have errors Option for offline, batch running of edits on large files and under heavy load conditions available File Upload

New Upload

Previous Uploads

Web Plus Administrator – Exporting File Uploads

Central Registries can post files for secure download by facilities Different files can be posted for different facilities Downloaded by the File Uploader at the facility Administrators can: Manage the files posted for download Download the files as well File Download

Web Plus File Download

Central Registry Reports System Log-ins Abstract Updates Abstract Searches Abstract Deletions Abstract Exports Abstract Releases Reports

Facility Reports Abstracts Submitted Sorted by Abstractor Abstracts Accessed Sorted by Patient Name Descriptive Statistics on Released Abstracts Activity Report HIPAA Accounting of Disclosure Report Reports

Follow-back Supervisor loads files of partially-filled abstracts generated from death certificate files Notification to physicians to log in and update the abstracts sent via upon upload of file – Follow-back records in the NAACCR layout for import into Web Plus Once posted, abstracts are processed via the regular Web Plus record flow – Can be rejected back to central registry for re-routing – Are released to central registry for review by Central Registry Abstractor/reviewer upon completion Follow-back Supervisor and Monitors track follow-back abstracts to ensure their resolution Web Plus Follow-back

Follow-back Supervisor Home Page Uploads files of partially-filled follow-back abstracts Manually adds follow-back abstracts online Tracks follow-back abstracts by uploaded file or by facility Generates and views Web Plus follow-back reports

Load Follow-back File

Send Notice

Track Follow-back Requests by File

Track Individual Abstracts

Track Follow-back Requests by Facility

Track Individual Abstracts by Facility

Central Registry Follow-back Reports

Web Plus Facility Abstractor Homepage

Facility Abstractor Update Follow-back Abstract

Facility Follow-back Reports

Thank You! Kathleen K. Thoburn, Sanjeev Baral, Joseph D. Rogers, National Center for Chronic Disease Prevention and Health Promotion Division of Cancer Prevention and Control The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.