1. Outpatient Clinic Reporting: Understanding the Landscape and Establishing Reporting Processes
Andrea Sipin-Baliwas
Los Angeles Cancer Surveillance Program
University of Southern California
NAACCR/IACR Meeting
June 11, 2019
Vancouver, Canada

2. EVOLVING LANDSCAPE
Delivery of cancer care is no longer exclusive to the hospital setting
Organizations are exploring ancillary revenue streams
Private practices are being acquired by larger entities
Advocacy for improving access to care
Cancer becomes a chronic disease

3. EVOLVING LANDSCAPE
Other reasons contributing to migration of care to clinics:
Availability of infusion pumps for chemotherapy
Antiemetic medication
Development of other targeted cancer therapies

4. EVOLVING LANDSCAPE Other entity in LAC with 10 outpatient clinics
Multi-specialty
Hematology/Oncology
Dermatology/Internal Med
Infusion Center
Radiology/Surgery/Transplant

5. PURPOSE
We aim to thoroughly evaluate the underreporting of cancer treatment data and incident cancer cases seen at free standing medical oncology clinics and establish reporting processes for this evolving landscape.

6. Disease Program (Diagnosis)
BACKGROUND
Partnered with City of Hope (COH) as they acquired new outpatient clinics in LAC
Case year 2016  2216 patients
8 facilities in Los Angeles County (LAC)
Full-service cancer centers
Radiation facilities
Medical oncology centers
Last Name
First Name
Middle Name
MRN
DOB
Radiation
Biopsy
Chemo
Disease Program (Diagnosis)
Facility Name
Doe
Jane
10/10/1965
NULL
Bone Cancer Prime
Facility A
John
1/7/1953
0Hem Lymphoma Prime
Facility B

7. METHODS Generate COH Clinical Case List
Review cases in statewide database
(In, Not In, Possible recurrence/mets)
Send annotated case list to COH
COH sends medical record files for cases as requested*
1) Add treatment or
2) Abstract new case
Process in statewide database
*Secure Web Portal for data exchange

8. RESULTS

9. CASE DISTRIBUTION – NEW CASES
Missed cases for 15 different cancer sites
Most common:
1) Prostate 2) Heme 3) Breast

10. CASE DISTRIBUTION – TREATMENT ONLY
Missed treatment for 21 different cancer sites
Most common:
1) Breast 2) Heme 3) Ovarian

11. EVOLVING LANDSCAPE
MISSING TREATMENT

12. EVOLVING LANDSCAPE REPORTING PROCESS
Created a new reporting source for the clinics
COH is responsible for reporting cases starting with 2017
Additional staff for increasing efforts
10 FTE requested
Registry will be the follow back contact
Establish expected caseload over time
Continue to open clinics and enter into partnerships

13. CONCLUSION Complete case capture is increasingly challenging
Linkages are an important resource (i.e. SEER pharmacy linkage)
Underreporting of Prostate cases
Significant underreporting of Chemotherapy, Radiation Tx, Multiple Modalities
Need to keep up with new reporting sources and establish reporting relationships
State policies will help enforce reporting requirements
Ensure complete electronic pathology reporting (AB 2325)

14. Co-Authors Dennis Deapen, DrPH Kelli Olsen, MS, CTR Camille Maristela
THANK YOU
Co-Authors Dennis Deapen, DrPH Kelli Olsen, MS, CTR Camille Maristela
The collection of cancer incidence data used in this study was supported by the California Department of Public Health pursuant to California Health and Safety Code Section ; Centers for Disease Control and Prevention’s (CDC) National Program of Cancer Registries, under cooperative agreement 5NU58DP006344; the National Cancer Institute’s Surveillance, Epidemiology and End Results Program under contract HHSN I awarded to the University of California, San Francisco, contract HHSN I awarded to the University of Southern California, and contract HHSN I awarded to the Public Health Institute.  The ideas and opinions expressed herein are those of the author(s) and do not necessarily reflect the opinions of the State of California, Department of Public Health, the National Cancer Institute, and the Centers for Disease Control and Prevention or their Contractors and Subcontractors.