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Manitoba Cervical Cancer Screening Program

Manitoba Cervical Cancer Screening Program . MCCSP Registry Infrastructure and Evaluation. CancerCare Manitoba . June 2009. www.everytwoyears.ca. Presentation Overview. Program Overview Registry Infrastructure Business Process Database Linkages Support and Maintenance

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Manitoba Cervical Cancer Screening Program

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  1. Manitoba Cervical Cancer Screening Program MCCSP Registry Infrastructure and Evaluation CancerCare Manitoba June 2009

  2. www.everytwoyears.ca Presentation Overview • Program Overview • Registry Infrastructure • Business Process • Database Linkages • Support and Maintenance • Upgrades and Change Requests • Information Utilization • Operations • Surveillance & Monitoring • Evaluation • Research

  3. www.everytwoyears.ca MCCSP Overview • Established January 2000 • Program of Manitoba Health • Managed by CancerCare Manitoba • Public Health Act Regulation (2009 & 2001) • 398,770 women age 18-69 (01-06-2008) • 7 cytology laboratory partners • 27 Colposcopists

  4. www.everytwoyears.ca MCCSP Program Guidelines • Screening starts with sexual activity • May stop at age 70 • Pap test annually x 3 • 3 Negative  2 years • Unsatisfactory/Low Grade = repeat 6-9 months • Persistent Unsat/Low Grade = colposcopy • High Grade = colposcopy

  5. www.everytwoyears.ca MCCSP Registry is…. • A confidential centralized database of all cervical cancer screening test results • Includes cytology, colposcopy, associated pathology • Demographic information on all females 18-69 • Regulated by the Cervical Cancer Screening Registry Regulation 31/2009

  6. www.everytwoyears.ca Registry Infrastructure • Screening Reports • Cytology (April 2001) • Colposcopy (January 2003) • Standardized nomenclature and dictionaries • Manitoba Health Population (18-69) • Hysterectomy tariff codes • Cancer Registry – cervical cancers • In Process • Population expansion (10-17) • Vaccination status (MIMS, DPIN/Health Admin • All Gynecological cancers

  7. www.everytwoyears.ca Information Systems • Computerized and automated • Manage dataflow and information needs • Information comes from • Laboratory test results • Colposcopy reports • Demographic data • Health care providers • Cancer Registry • Manitoba Health databases • Gather and consolidate data • Relies on the cooperation of the health care community

  8. www.everytwoyears.ca System Infrastructure (Literally) • Database Server • Linux • Oracle 10 • EDI Server • M/S Windows NT • LAN network HUB (10/100 Base T Ethernet) • IP Routers • To external laboratories • Modem to modem communication • To Manitoba Health WAN

  9. www.everytwoyears.ca Business Processes • Acquire report data (electronic and manual) • Enter/edit report data • Process reports • Edit/check and validate • Link data on individuals • Determine follow up events • Perform QA • Query individual’s screening histories

  10. www.everytwoyears.ca Business Processes Cont’d • Generate follow up reminders • Generate standard reports • Consolidate • Cancer data • Hysterectomy data • Population data • Duplicates • Perform data queries • Perform system administration • Provide electronic histories to cytology laboratories

  11. www.everytwoyears.ca Electronic Transmissions from Laboratories

  12. www.everytwoyears.ca File Upload Process • Population Upload • Data from Manitoba Health • Modem to modem connection • Data is FTPd to Cervical Cancer Screening Server • ISIS software • Population upload function • Match by PHIN, surname, DOB • Update patient demographics • Population Table

  13. www.everytwoyears.ca File Upload Process Cont’d • Cancer Upload Process • Data from Cancer Registry system • Maxon Database (Sybase) • SQL script • Extracted data is FTPd to Cervical Cancer Screening Server • ISIS software • Cancer Upload Function • Match by PHIN, surname, DOB/ Cancer Number/Dx Date • Updates patient cancer information • Cancer Table

  14. www.everytwoyears.ca Reports • ISIS software generated reports • CCSP reporting • PowerBuilder programs • Extracted from Oracle Database • Population based • RHA/FSA • Health Care Provider Reports • Ad-hoc reports extracted to EXCEL (also Comma Separated Values, ASCII text, dBase 2/3, Data Interchange Format, Lotus)

  15. www.everytwoyears.ca Database Linkages • Cytology Laboratories (electronic transmission) • PHIA compliant • Results • CPSM MANQAP Quality Standards • Manitoba Health • Population • Administrative Databases • MIMS • DPIN • Cancer Registry • Future Pathology Laboratory Linkage through E-Path (AIM)

  16. www.everytwoyears.ca Support & Maintenance • CCMB Health Information Services • Project management/application support and development • System administration • Database management • Hardware maintenance for Cytology laboratory systems • Electronic linkage (Transmed) • MCCSP Team • Program management • Data entry • Quality assurance • Development of Requests for Change • User acceptance testing • Artificial Intelligence in Medicine (AIM) • Upgrades • New developments • Support for Laboratory Data Interface Improvements at laboratories

  17. www.everytwoyears.ca Support & Maintenance Cont’d • ISIS Production Database • ISIS Production Patient Inquiry • ISIS Test Database • ISIS Test Patient Inquiry • Transmed • FTP Script • Database SQL Scripts • Cancer Extract SQL Script • PowerBuilder Reporting Application

  18. www.everytwoyears.ca Upgrades and Change Requests • Annual support maintenance (AIM) • Quarterly submissions • Quarterly upgrades • Testing at AIM • Remote testing by AIM • User acceptance testing at MCCSP • Production implementation by CCMB HIS

  19. www.everytwoyears.ca Information Utilization • Operations • Surveillance/Monitoring • Recruitment and Promotion • Evaluation • Research

  20. www.everytwoyears.ca Operations • Opt out (21) • Screening Results to • Women (empowers and educates) • Cytology laboratories (MANQAP Reporting/QA) • Health care providers (improves clinical management and educates on screening guidelines) • Follow Up and Monitoring • High Grade Abnormal Results (January 2003) • Low Grade Abnormal Results (April 2006) • Letters to health care providers • Letters to women

  21. www.everytwoyears.ca Surveillance • Screening patterns by • Age • RHA • FSA • Time • Abnormal Pap test management and follow up • Workload • Cytology • Colposcopy • Provider • Impact on participation, abnormalities, cancer incidence

  22. www.everytwoyears.ca Recruitment and Promotion • Definition of eligible population • Recruitment letters • Reminder letters • Target populations and communities • Pap Test Learning Module

  23. www.everytwoyears.ca Evaluation • Reaching target populations • Statistical reports • Pap Clinic Week

  24. www.everytwoyears.ca Research • Cancer incidence and screening participation • HPV Pilot Study (2006) • HPV Surveillance (2008) • Pap test utilization and impact of recruitment letters (2010)

  25. www.everytwoyears.ca Future Questions • Manitoba Cervical Cancer Screening Program • 788-8627 • 1-866-616-8805 • MCCSP@cancercare.mb.ca • EveryTwoYears.ca • TellEveryWoman.ca • Women can call for copies of their own results

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