1. Seattle/Puget Sound SEER Registry CSv2 Implementation Stories from the Front Lines
Mary Potts, RHIA, CPA, CTR, Manager
Jennifer Hafterson, CTR, Field Operations Supervisor
Fred Hutchinson Cancer Research Center
June 2010

2. Setting the Seattle scene
Change from abstract-centric to bit-centric
Change our database management system (SEER*DMS)
Change our abstracting software (SEER*Abs)
Change from mostly electronic to all electronic
Add CSv2 into the mix for seasoning

3. It takes everyone on staff
Be a positive leader
Believe in your team
Record issues daily in a central location
Respond daily to issues
Make decisions daily

4. The Implementation Guide
Print it
Assign it
Read it
Mark it
Discuss it

5. When did we start? Went live Feb 16, 2010 on SEER*DMS and CSv2
Our CSv2 upgrade tied to our SEER*DMS deployment
Our SEER*DMS deployment was tied to our need to start 2010 cases
Nearly 95% initial reporting of 2009 cases pre-upgrade
Upgrading is not simply a matter of adding SSF 7 through SSF 25 fields
Existing data undergoes a conversion

6. Our major issues - 1 Breaking the paper addiction
Part II of the CSv2 Manual with all the site-specific schemes
Lack of CS edits to help guide staff
Edits help us understand the intention of the workgroups who drafted the new schemas

7. Our major issues - 2 Welcome to the Obsolete World!
Obsolete Data Retained
Obsolete Data Converted
Obsolete Data Converted and Retained
Obsolete Data Reviewed and Changed

8. Our major issues - 3 Bye-bye 888. Hello 987 and the twins, 988.
888 = not applicable (CSv1)
987 = SSF not applicable because the case does not meet all the conditions for its use
988 = a) SSF not applicable because not defined b) SSF not applicable because the registry has chosen not to collect a defined, but not required, SSF field
Does 988b or 999 win in case consolidation?
999 = unknown or no information

9. Our major issues - 4 After the upgrade to CSv2
If you receive a NAACCR 11 abstract for a pre-2010 case, can you use the values in the Obsolete Data Retained fields?
If you have a correction to one CS field on a pre-2010 case, do you have to bring all the fields to CSv2?
Whatever does one do with the CS Version Input Current field?

10. Communication is key

11. Stop dithering, start coding
Accept – Greater understanding comes with using the schemas and the manual
End – The theoretical “what if” discussions
Start – The practical application; code the cases
Recognize – Initial coding will be less than perfect
Know – Consistency will improve with every month of experience applying the rules

12. Breakthrough moments

13. Where are we now? Aiming for consistency Testing that counts
CSv2, Part I, Section 1, General Rules
CSv2, Part I, Section 2, Lab Tests, Tumor Markers, and Site-Specific Factor Notes
5 cases each for the 7 largest site groups
One test case a day
Adjust accordingly -- As CSv2 issues are addressed in I&R, we will adjust our coding practice

14. Successful conclusion of initial implementation

15. CSv2 Implementation Issues Team

16. Any Questions for Seattle