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Outpatient Clinic Reporting: Understanding the Landscape and Establishing Reporting Processes

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. EVOLVING LANDSCAPE.

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Outpatient Clinic Reporting: Understanding the Landscape and Establishing Reporting Processes

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  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. 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

  7. METHODS *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. 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 103885; 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 HHSN261201800032I awarded to the University of California, San Francisco, contract HHSN261201800015I awarded to the University of Southern California, and contract HHSN261201800009I 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.

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