NPCR-AERRO: Electronic Pathology (ePath) and Biomarker Synoptic Reporting Activities Sandy Jones, Public Health Advisor Cancer Surveillance Branch Division of Cancer Prevention and Control Centers for Disease Control and Prevention (CDC) Not enough coffee in the world to finish those narrative reports?
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NPCR-AERRO: Not enough Electronic Pathology (ePath) · PDF fileNPCR-AERRO: Electronic Pathology (ePath) and Biomarker Synoptic Reporting Activities Sandy Jones, Public Health Advisor
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NPCR-AERRO: Electronic Pathology (ePath)
and Biomarker Synoptic Reporting Activities
Sandy Jones, Public Health AdvisorCancer Surveillance Branch
Division of Cancer Prevention and ControlCenters for Disease Control and Prevention (CDC)
Not enough coffee in the world to finish those narrative reports?
Good Morning.
• U.S. Laboratories still produce narrative reports
• Non-standard across labs
• Time-consuming
• Enhance data completeness, timeliness, and quality using the CAP Cancer Protocols and electronic Cancer Checklists (eCC)
Background and Purpose
Presenter
Presentation Notes
Development of CAP Cancer
Pathology and Biomarker Templates
Laboratory Systems to
Integrate and Implement
Pathologists to Use
Laboratories to Report to
Cancer Registries
Overview of Necessary Components
Presenter
Presentation Notes
CDC and CAP collaborated to develop CAP pathology and biomarker templates to standardize the collection of pathology and biomarker test data at the pathologist level and stored in the laboratory information systems for consistent data exchange with clients and public health. Laboratory vendors must integrate the templates into their laboratory information management systems and these systems must be implemented in laboratories for use. Pathologists must use the checklists that are provided in their laboratory information management system. Laboratories must report the template data in the NAACCR Volume V standard format to cancer registries.
The Stars are aligning…
• NPCR-AERRO ePath Project began working with national laboratories to transmit narrative reports using NAACCR Volume V in 2006
• CAP eCCs first published in 2007
• CAP Cancer Protocols cancer reporting gold–standard since 1984
• Cancer Care Ontario (CCO) implemented a CCO-developed checklist in 2008 and implemented the CAP eCCs from 2010-2012
• PathGroup implemented CAP eCCs in 2012
• CA pilot project with St. Joseph’s Health, CAP, and mTuitive began in January 2014
Project Collaboration for Greater Impact
CDC NPCR-AERRO ePath Project
Implement laboratory
reporting to all cancer registries
CAP eCC Project
Implement CAP eCC in hospital
laboratory information systems (LIS)
California Pilot ProjectImplement reporting of CAP eCC data from
California hospitals to cancer registry
• Use NAACCR Volume V• HL7 2.3.1 or 2.5.1 ORU message for narrative
reports
• Established ICD-10-CM filter to identify cancer cases for reporting
• Core vs. Expanded
• Use Public Health Information Network Messaging System (PHINMS) for secure message transport
• Currently implemented ePath reporting from 25 national/regional labs to over 40 registries
Update on CDC NPCR-AERRO ePath Project
Using PHINMS for Cancer ReportingPHINMS installation for Cancer Reporting in ProgressParticipation via sFTP or other methods
D.C.
ePath Project Participants as of May 2016
Not participating in ePath Project
CAP Cancer Pathology and Biomarker Templates
Source: Cancer Protocols on www.cap.org
• 3,162 pathologists using checklists
• 96 CAP Cancer eCCs, including 13 Biomarker Templates– Breast Biomarkers– Stomach: Gastric HER2 Biomarkers– Lung Biomarkers, Non-Small Cell
Total of 60 facilities use CAP eCCs (~80% of all PathGroup facilities)
PathGroup Implementation Activities
Secure TransportSetup, configure, and test PHINMS
HL7 ORU MessageNAACCR Vol. V specification for narrative and CAP eCC reports
CAP ChecklistMap eCC data elements to HL7 message
Implement and train staff in Marin General
Reporting
Filter cases based on ICD-10
Patient state of residence
Presenter
Presentation Notes
Secure Transport Setup, configure, and test PHINMS (same transport will be used for narrative and synoptic reports) HL7 ORU Message NAACCR Vol. V specification for narrative and checklist reports (narrative reports and checklist reports will be submitted as separate OBR/OBX pairs in the same message) CAP Checklist Map checklist elements to HL7 message (ensured that modifications being made for checklist implementation would be consistent (where possible) with narrative reporting.) Implement and train staff in Marin General Hospital (Had Medical Director meet with Marin General Director to get agreement to implement CAP Cancer Checklists, added functionality in Marin Hospital system to utilize checklists, providing training to Marin Hospital staff in use of checklists, new workflow, and updated system.) Reporting Filter cases based on ICD-10 (Using “Core” and “Expanded” Reportability Lists) Patient state of residence
Sample PathGroup HL7 Message
Strategies to increase use of CAP eCCs
Describe benefits to laboratories
Demonstrate ease of use for pathologists
Introduce use of eCCs at academic level
Market to standard setters at national level
Market to labs, pathologists and lab system vendors
Market to oncologists and other physician specialists
Acknowledgement of Co-Authors
• Barb Weatherby – DB Consulting Contractor• Joseph D. Rogers
• Kurt Snipes Daniel Hollingsworth• Jeremy Pine Tim DavidsonCalifornia Cancer Registry
• Ted KleinKlein Consulting Informatics LLC
• Gemma LeeCancer Care Ontario
Questions?
For more information please contact Centers for Disease Control and Prevention
1600 Clifton Road NE, Atlanta, GA 30333Telephone: 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348Visit: www.cdc.gov | Contact CDC at: 1-800-CDC-INFO or www.cdc.gov/info
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
National Center for Chronic Disease Prevention and Health PromotionDivision of Cancer Prevention and Control