Transcript Say Goodbye to Paper: Web-based Reporting is Here!

Say Goodbye to Paper:
Web-Based Reporting is Here!
Iris Zachary, MS, CTR, Missouri Cancer Registry
Acknowledgements
Missouri Cancer Registry:
• Nancy Cole, CTR
• Sue Vest, CTR
• J. Jackson-Thompson, MSPH, PhD
MCR
Missouri Cancer Registry
This project was supported in part by a cooperative agreement
between the Centers for Disease Control and Prevention (CDC)
and the Missouri Department of Health and Senior Services
(DHSS) (#U55/CCU721904) and a Surveillance contract between
DHSS and the University of Missouri.
MCR’s Goals
• Offer a web-based reporting mechanism
for physicians;
• Increase the number of cancer cases
reported to the central registry; and
• Reduce central registry staff effort.
Background
• Missouri physicians required to report only if
case not reported by another entity
• Dermatologists began reporting on paper in
2004
– (> 160 + general surgeons, plastic surgeons, etc.)
• Urologists not reporting yet
– (> 160)
Background
• Many types of cancer being diagnosed and
treated completely outside the hospital
setting
– Prostate
– Melanoma
– Breast
– Leukemia
Prostate Project with CDC
• In 2005, MCR selected as one of 8 central
cancer registries (CCRs) to participate in a
pilot project.
• Purpose: Pilot use of web-based (Web
Plus) reporting to increase physician
reporting of genitourinary system cancers.
What is Web Plus?
• Secure, web-based application;
• Developed by CDC with input from
CCRs;
• Offered free of charge to CCRs;
• Technical support provided by CDC;
Advantages of Web Plus
• Software can be modified/enhanced
to meet needs of participating CCRs.
• Facilities can directly enter data and
submit cases on-line.
Web Plus
• CCR hosts servers
• CCR sets up user accounts
– Users log directly into CCR server
– User can only access his account
• Multiple security features
Key elements of Web Plus
• Customizable features
– Create displays for specific cancer sites
– Change field names to basic English (PSA value
rather than CSSSF 1)
– Add help messages specific to a particular cancer site
– Set defaults based on cancer site
• Make fields invisible
– Set critical fields (text, etc.)
– Move fields to any position
Lessons….
• Physicians are not aware that cancer
registries have national standards for
codes.
• Physicians and staff are overwhelmed by
the number of fields
Lessons….
• Training needs depend on the person
who will be completing electronic
forms (physician, RN, medical assistant, etc.)
– Familiarity with cancer and cancer reporting
terminology (e.g. histology)
– Familiarity with chart
– Physicians
Lessons…..
• Labels for items must be changed to plain
English (e.g., “CSSSF1” to “PSA value”)
– Field labels do not have to be NAACCR field names
– Must have CS reference in case of edit errors
• Can select critical fields, including text fields
• Can customize boxes that offer instructions for
completing fields
Lessons….the use of text fields
• Physician
– REDUNDANT!!!!
– Unnecessary
– I won’t complete
• Staff
– Way to QA (for CCR and for them)
– Makes them think about the codes they’ve chosen
Lessons…..
• Physicians and staff, though unfamiliar with
collaborative staging, actually have enough
information to stage cases for certain
primary sites
– CS fields (extension, lymph nodes, etc.)
– CSSSF fields ( PSA values, Gleason’s score,
etc.)
Lessons….
• Hospital cancer registrars can be your ally
– Recruiting physicians
– Training staff
– Serving as ongoing resource to office staff for
questions
Summary
• Year-long project results:
– Urologists were not ready to report on paper or
electronically
– Web Plus features make it easy to use for a variety of
functions
– MCR will continue to use Web Plus, with a focus on
converting dermatologists from paper to web-based
system, then focus on getting cases from urologists
Applying what we learned to
web-based melanoma reporting
Project differences
PROSTATE
• One site
• 1-2 histologies
• Little diagnostic/treatment
coding
– Biopsy info
– No surgery, radiation or
chemo
• CS factors
• Case finding
MELANOMA
• Multiple sites
• Multiple histologies
• Confusion about codes
for diagnostic procedure
vs. surgical procedure
– Excisional biopsy
• CS factors
• Case finding
Decisions
• What is the least amount of information we
can accept?
• How can we make this as easy as
possible?
• If it is too difficult/time-consuming, they
may not report at all.
How many fields?
• Can we eliminate some?
• Default – make invisible?
• Default – leave visible (in case they do
need to use it)?
Use of codes
• Can they do it?
– All fields
– Specific fields
– Text
• Show same slide for melanoma display
• Show same slide for melanoma display
Issues at MCR
•
•
•
•
Training users
Issuing Passwords (practice vs. individual)
Managing hundreds of accounts
Determining responsibilities and workflow
at CCR
Web Plus Future Enhancements
• CCR can start the form on Web Plus
(manually or via an electronic path lab file)
• CCR notifies physician that form is waiting
to be completed
• Physician office staff can log on to Web
Plus, complete and release form to CCR
Disadvantages of Web-Based
reporting
• Lose the paper – lose the info contained on the
paper
• Still labor intensive, but in a different manner
• Must develop good tracking systems (FB, etc.)
• Managing potentially hundreds of accounts
requires attention to detail
Advantages of web-based reporting
• Process more cases in the same amount
of time
• No more paper to file
• Increased security
• Reduce data entry/ error
Future uses
• Death clearance follow-back
• Path lab follow-back
• Utilizing e-path files for follow-back
MCR Staff
Shari El Shoubasi
Web Plus Coordinator
Toll-free: 866 240-8809
573 884-6928
Email: [email protected]
MCR Staff (cont.)
Nancy Cole
Non-Hospital Reporting Coordinator
Toll-free: 866-240-8809
Phone: 573-884-2491
Email: [email protected]
Missouri -- http://mcr.umh.edu/
• https://webplus.umh.edu/webplus
– Prostate
• User ID: johndoe
• Password: test
– Melanoma
• User ID: janedoe
• Password: test