An Outline of Automated Cancer Registration Chris Carrigan National Coordinator for Cancer Registration in England For the Automated Cancer Registration Workshop Wednesday 4 th December 2002

What is Automation? Application of Procedures Suited to Repetitive Tasks Eliminates Variability Standardisation Speed, Efficiency, Consistency Based on Rules Mechanism to Apply the Rules

Why Automate? Consistency / Standardisation Better use of Resource (People/Machines) Increasing Electronic Sources –Cancer Waiting Times –National Clinical Audit Support Programme –NHS Messaging Programme –Death Certification –Cross-Registry Transfers

Why Automate….? Capacity Respond to Change Improve Speed Shift the Balance: From Process To Service Delivery

Cancer Registry NSTS Demographics Waiting Times CMDS ONS Deaths Pathology Procedures Staging Death Cert Newly Diagnosed Screening Programmes Screen History Radiotherapy Prescription Chemo/ Hormone Radiotherapy

Transactions by Calendar Year

Opportunities Cancer Information Hub Data Quality Assurance Local Intelligence National Intelligence Value-Added Service Delivery

Understanding Automation Methods of Representation..

National Specification Project Delivery Services Model Process Model Rules Model Data Model

Initial data cleanse validate and format Patient matching Create provisional patient record Tumour matching Update/add tumour record Update/add treatment record (if data provided) Update/add death details (if data provided) Overall Cancer Registration Process

Receive & log data Reformat record Discard record Record already received in batch? Are mandatory patient items there? Does data need formatting? Yes No Yes No Match against database Yes Is translation needed? Translate specific data items Yes Initial data cleanse & format (Pre-registration processing) Add derived data items e.g. basis No Are specific data items valid? Data review & correction No Yes Match against NSTS No Data review & correction No Yes Discard record No Patient Matching Are items now there? Complex !

Loading / Translation Validation Stages of Automation - Simplified Linkage Survivorship ????

Patient Linkage Tumour Linkage Linkage and Survivorship Survivorship Tumour Linkage

Development Lifecycle Define Rules Establish Test Data Define Test ResultsPerform Tests Improve Rules Review Errors Develop Software Clinical I.T. Clinical I.T. Clinical and I.T. Clinical and I.T.

Example An automated process..

Tumour Linkage Inputs Source Identifier Site, Morphology and Side Event Date Outputs Definite Match, New Tumour, No Decision

Example Inputs and Outputs Inputs Hospital Admission, Nasal Cavity (C30.0) on 25th May 1999 Pathology Result, T2X120, M82703 on 5th June 1999 Output Definite Match

Key Messages React to Increasing Volume Change the Balance of Process Change the Emphasis of Purpose Focus on Service Delivery Recognise Specialist Capabilities Need for Collaboration Standardisation Benefits Realisation

National Requirements PROVIDE A NATIONAL CANCER REGISTRATION SERVICE INFORMATION

UKACR Web Site Links to –Today's Presentations –ENCR Automated Registration Website

Automation in Registry Practice Joint presentation by –Northern Ireland Cancer Registry –Trent Cancer Registry –Thames Cancer Registry South West Cancer Intelligence Service ONS

An Outline of Automated Cancer Registration Chris Carrigan National Coordinator for Cancer Registration in England For the Automated Cancer Registration Workshop Wednesday 4 th December 2002