Clinician Reporting to Public Health Repository (Cancer Registry) Brief Profile Proposal for presented to the QRPH Planning Committee Wendy Scharber, RHIT, CTR Wendy Blumenthal, MPH September 29, 2009

IT Infrastructure Planning Committee The Problem Cancer is a reportable disease in the United States and public health has had cancer registries for over three decades. The traditional reporting sources include hospitals and pathology laboratories.Cancer is a reportable disease in the United States and public health has had cancer registries for over three decades. The traditional reporting sources include hospitals and pathology laboratories. As medical advances have occurred, diagnosis and treatment of certain cancers has moved from the acute care setting to being fully cared for within the physician/clinic office.As medical advances have occurred, diagnosis and treatment of certain cancers has moved from the acute care setting to being fully cared for within the physician/clinic office. Because cancer registries have not required physicians to actively report cancer cases, under-reporting or a delay in reporting is occurring.Because cancer registries have not required physicians to actively report cancer cases, under-reporting or a delay in reporting is occurring. Incidence rates and research are adversely affected by the incomplete data collection.Incidence rates and research are adversely affected by the incomplete data collection.

IT Infrastructure Planning Committee Use Case When the physician documents an encounter with a cancer patient: The EMR checks to see if the diagnosis meets the criteria for reporting to the state cancer registryThe EMR checks to see if the diagnosis meets the criteria for reporting to the state cancer registry Meeting the criteria the EMR displays the cancer reporting form, pre-populating most of the form with information from the EMR.Meeting the criteria the EMR displays the cancer reporting form, pre-populating most of the form with information from the EMR. The physician reviews the form, completes the remaining information, and submits the electronic form. to the cancer registry immediately.The physician reviews the form, completes the remaining information, and submits the electronic form. to the cancer registry immediately. The cancer registry receives the form and updates their database in a timely manner.The cancer registry receives the form and updates their database in a timely manner.

IT Infrastructure Planning Committee Proposed Standards & Systems Does not identify/solve any IHE profile gaps/overlaps Uses EXISTING IHE constructs.Does not identify/solve any IHE profile gaps/overlaps Uses EXISTING IHE constructs. –Demonstrates IHE’s position that its end products can be re-used. Standards & SystemsStandards & Systems –IHE Request Form for Display (RFD) –IHE Clinical Research Data Capture (CRD) –HITSP C76: Case Report Pre-populate Component –HITSP TP50: Retrieve Form for Data Capture Transaction Package Retrieve Form for Data Capture Transaction PackageRetrieve Form for Data Capture Transaction Package –HITSP T66: Retrieve Value Set Transaction –Supporting Infrastructure PHIN VADS for reportability criteria and standardizing data element valuesPHIN VADS for reportability criteria and standardizing data element values Form Filler, Forms Manager, Form Archiver, Form ReceiverForm Filler, Forms Manager, Form Archiver, Form Receiver SecuritySecurity

IT Infrastructure Planning Committee Discussion Has been prototyped and demonstrated at PHIN Conference with very positive feedback.Has been prototyped and demonstrated at PHIN Conference with very positive feedback. CDC’s NPCR’s Advancing e-Cancer Reporting and Registry Operations (NPCR-AERRO) has convened a workgroup to develop consensus standards in the US for this use caseCDC’s NPCR’s Advancing e-Cancer Reporting and Registry Operations (NPCR-AERRO) has convened a workgroup to develop consensus standards in the US for this use case 26 central cancer registries26 central cancer registries 3 federal government entities as cancer registry stakeholders3 federal government entities as cancer registry stakeholders 3 cancer registry software vendors3 cancer registry software vendors 4 universities4 universities CAP, NAACCR, NCRA, AHIMA, Canadian Partnership Against Cancer (CPAC)CAP, NAACCR, NCRA, AHIMA, Canadian Partnership Against Cancer (CPAC) If not selected this cycle, we risk losing stakeholders’ interest and the momentum for the use case.If not selected this cycle, we risk losing stakeholders’ interest and the momentum for the use case. Should require less resources as it uses existing IHE “things”Should require less resources as it uses existing IHE “things” –Prototype took less than 4 weeks to develop –An EMR Partner is interested in pilot testing now

IT Infrastructure Planning Committee Discussion The value of this use case is that it can be applied to many public health programs where the physician is required to notify a central agency (i.e. Health Department) of a diagnosed health condition.The value of this use case is that it can be applied to many public health programs where the physician is required to notify a central agency (i.e. Health Department) of a diagnosed health condition. This profile can serve as the proof of concept for other public health data collection initiatives.This profile can serve as the proof of concept for other public health data collection initiatives. –Which is why its title is Public Health Repository, rather than just Cancer Registry.

IT Infrastructure Planning Committee Logistics Profile Editors:Profile Editors: –Wendy Scharber – CDC-NPCR (Contractor) –Wendy Blumenthal – CDC-NPCR