Clinician Reporting to Public Health Repository (Cancer Registry)

1. Clinician Reporting to Public Health Repository (Cancer Registry) Brief Profile Proposal for 2010 - 2011 presented to the QRPH Planning Committee Wendy Scharber, RHIT, CTR Wendy Blumenthal, MPH September 29, 2009

2. The Problem • Cancer is a reportable disease in the United States and public health has had cancer registries for over three decades. The traditional reporting sources include hospitals and pathology laboratories. • As medical advances have occurred, diagnosis and treatment of certain cancers has moved from the acute care setting to being fully cared for within the physician/clinic office. • Because cancer registries have not required physicians to actively report cancer cases, under-reporting or a delay in reporting is occurring. • Incidence rates and research are adversely affected by the incomplete data collection.

3. Use Case When the physician documents an encounter with a cancer patient: • The EMR checks to see if the diagnosis meets the criteria for reporting to the state cancer registry • Meeting the criteria the EMR displays the cancer reporting form, pre-populating most of the form with information from the EMR. • The physician reviews the form, completes the remaining information, and submits the electronic form. to the cancer registry immediately. • The cancer registry receives the form and updates their database in a timely manner.

4. Proposed Standards & Systems • Does not identify/solve any IHE profile gaps/overlaps Uses EXISTING IHE constructs. • Demonstrates IHE’s position that its end products can be re-used. • Standards & Systems • IHE Request Form for Display (RFD) • IHE Clinical Research Data Capture (CRD) • HITSP C76: Case Report Pre-populate Component • HITSP TP50: Retrieve Form for Data Capture Transaction Package • HITSP T66: Retrieve Value Set Transaction • Supporting Infrastructure • PHIN VADS for reportability criteria and standardizing data element values • Form Filler, Forms Manager, Form Archiver, Form Receiver • Security

5. Discussion • Has been prototyped and demonstrated at PHIN Conference with very positive feedback. • CDC’s NPCR’s Advancing e-Cancer Reporting and Registry Operations (NPCR-AERRO) has convened a workgroup to develop consensus standards in the US for this use case • 26 central cancer registries • 3 federal government entities as cancer registry stakeholders • 3 cancer registry software vendors • 4 universities • CAP, NAACCR, NCRA, AHIMA, Canadian Partnership Against Cancer (CPAC) • If not selected this cycle, we risk losing stakeholders’ interest and the momentum for the use case. • Should require less resources as it uses existing IHE “things” • Prototype took less than 4 weeks to develop • An EMR Partner is interested in pilot testing now

6. Discussion • The value of this use case is that it can be applied to many public health programs where the physician is required to notify a central agency (i.e. Health Department) of a diagnosed health condition. • This profile can serve as the proof of concept for other public health data collection initiatives. • Which is why its title is Public Health Repository, rather than just Cancer Registry.

7. Logistics • Profile Editors: • Wendy Scharber – CDC-NPCR (Contractor) • Wendy Blumenthal – CDC-NPCR