1. NPCR – Advancing E-cancer Reporting and Registry Operations (NPCR-AERRO): An Update on Innovative Activities NAACCR Annual Conference June 16, 2009 Sandy Thames Public Health Advisor National Program of Cancer Registries, CDC

2. Name Change NPCR-Modeling Electronic Reporting Project (NPCR-MERP) name change needed To represent expanded activities that include: Modeling Analysis and Design Implementation –New Name: Advancing E-cancer Reporting and Registry Operations (NPCR- AERRO) White Paper on NPCR-AERRO: Developing a Cancer Surveillance Informatics Structure in the New E-Health Environment – April 2009 –http://www.cdc.gov/cancer/npcr/npcrpdfs/npcr_aerro_overview.pdfhttp://www.cdc.gov/cancer/npcr/npcrpdfs/npcr_aerro_overview.pdf

3. NPCR-AERRO Develop best practices, guidelines, and recommendations for an ideal cancer surveillance informatics infrastructure Use a collaborative, consensus-building framework to construct a comprehensive model to demonstrate the potential of electronic cancer registry reporting and automated registration

4. NPCR-AERRO Goals Improve completeness, timeliness, and quality of data Reduce costs for registries and data providers significantly over time Develop a “blueprint” to identify priorities that will make better use of cancer surveillance resources Provide guidance for development of standards based systems for cancer registries Improve data exchange between systems through use of industry standards

5. Implementation: Coordinate, lead, and support software vendors, hospitals, and state cancer registries pilot testing NPCR-AERRO models and products. Analysis and Design: Analyze current technology and infrastructure surrounding registry operations and develop products supporting automation and electronic reporting. Modeling: Develop consensus best practice models for automating processes and electronic reporting NPCR-AERRO Approach

6. Modeling Activities – Completed Hospital Operations –Prepare and Transmit Event Report –Receive Batch File –Validate Event Report –Perform Casefinding and Passive Follow-up –Perform Abstracting –Validate and Edit Abstracted Data –Conduct Active Follow-up –Perform Quality Assurance/Quality Improvement –Submit Data to CCR and NCDB

7. Modeling Activities – Completed Central Cancer Registry –Prepare and Transmit Event Report –Receive Batch File –Validate Event Report –Perform Patient Linkage –Perform Casefinding Audits –Perform Quality Assurance/Quality Improvement –Perform External Linkage to Improve Data

8. Modeling Activities – Completed Cancer Control and Data Use –Develop Business Use Case and Domain Diagrams –Describe benefits of EHR to cancer control –Examine short- and long-term data needs types of data used how the data are used data sources challenges to data collection and/or use –Identify existing and new knowledge products

9. Modeling Activities – Current/Future Clinical Care Providers (Physician Offices) Claims Pathology Reporting Process: CAP Cancer Checklists National eHealth Initiatives On-going maintenance

10. Analysis/Design Activities - Current Hospital: –Abstracting Use Case - Evaluate data items that can be pre-populated from Electronic Medical Record (EMR) –Data Transmission Standards –Webinar with Hospital Cancer Registry Vendors Central Cancer Registry: –Discharge Data and Medical Record Disease Index –Define reports/timeline for data source submission –Define standard naming convention of data source reports –Visual Editing

11. Analysis/Design Activities - Current Cancer Control and Data Use: –Map EHR data items to cancer data needs Data TypeData SourcesPurpose HITSP PH Case Reporting Data Elements Tx Medical records, primarily from medical oncology clinics Cancer registries have good data from hospitals vs. other data sources Assess access to quality care Measure timeliness of follow-up on abnormal results Use of appropriate therapies Measure timeliness for excisional biopsy (1st course of treatment) Present in EHR: Admin of tx Date admin of tx Name of tx Hospitalization Admission date Discharge date Hospital name Recovered Death

12. Analysis/Design Activities - Current E-Health Initiatives: –Develop a CSTE Position Statement and Implementation Guide for Cancer Reporting –Collaborate with IHE Anatomical Pathology Domain to implement a Pathology Profile in EHR software –Collaborate with EHR software vendors through IHE to implement a Clinical Care Reporting Profile

13. Implementation Activities - Current Electronic Pathology Reporting Project eMaRC Plus (formerly Mapper Plus) Visual Editing Tool HIMSS/IHE: –Test implementation of IHE Pathology Profile –Test implementation of IHE Retrieve Form for Data Capture (RFD) Consolidated Glossary Tool

14. NPCR-AERRO Website and CyberView Updated NPCR-AERRO Website New CyberView website provides: –Model drill down capability –Model Map and list of models for quick access to any level of detail –Glossary of Terms and references used in the project http://www.cdc.gov/cancer/npcr/informatics/aerro/

15. Thank you Sandy Thames 770-488-5689 sthames@cdc.gov The findings and conclusions in this presentation are those of the author(s) and do not necessarily represent the views of the Centers for Disease Control and Prevention