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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
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An Outline of Automated Cancer Registration Chris Carrigan National Coordinator for Cancer Registration in England For the Automated Cancer Registration Workshop Wednesday 4th 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
Radiotherapy NSTS ONS Deaths Radiotherapy Demographics Death Cert Cancer Registry Screen History Newly Diagnosed Waiting Times Screening Programmes Staging Procedures Chemo/ Hormone Pathology CMDS Prescription
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 (if data provided) Update/add treatment record (if data provided) Update/add death details Overall Cancer Registration Process
No Yes Does data need formatting? Is translation needed? Translate specific data items Receive & log data Yes Reformat record No Are specific data items valid? Are mandatory patient items there? Record already received in batch? Yes Yes No Discard record Complex ! Yes No Yes No Match against database Data review & correction No Yes Match against NSTS Add derived data items e.g. basis Are items now there? No Data review & correction Yes Patient Matching No Initial data cleanse & format (Pre-registration processing) Discard record
Stages of Automation - Simplified • Loading / Translation • Validation ? ? • Linkage • Survivorship
Linkage and Survivorship Patient Linkage Tumour Linkage Tumour Linkage Survivorship Survivorship
Development Lifecycle Clinical Define Rules Improve Rules Develop Software Clinical and I.T. I.T. Establish Test Data Review Errors Clinical and I.T. Clinical Perform Tests Define Test Results I.T. Clinical
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
INFORMATION National Requirements PROVIDE A NATIONAL CANCER REGISTRATION SERVICE
UKACR Web Site • Links to • Today's Presentations • ENCR Automated Registration Website
An Outline of Automated Cancer Registration Chris Carrigan National Coordinator for Cancer Registration in England For the Automated Cancer Registration Workshop Wednesday 4th December 2002