Transcript Cancer Care Manitoba

MCCSP Registry Infrastructure
and Evaluation
Manitoba Cervical Cancer
Screening Program
CancerCare Manitoba
June 2009
www.everytwoyears.ca
Presentation Overview
• Program Overview
• Registry Infrastructure
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Business Process
Database Linkages
Support and Maintenance
Upgrades and Change Requests
• Information Utilization
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Operations
Surveillance & Monitoring
Evaluation
Research
www.everytwoyears.ca
MCCSP Overview
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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
www.everytwoyears.ca
MCCSP Program
Guidelines
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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
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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
www.everytwoyears.ca
Registry Infrastructure
• Screening Reports
– Cytology (April 2001)
– Colposcopy (January 2003)
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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
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Information Systems
• Computerized and automated
– Manage dataflow and information needs
• Information comes from
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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
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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
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Business Processes
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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
www.everytwoyears.ca
Business Processes Cont’d
• Generate follow up reminders
• Generate standard reports
• Consolidate
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Cancer data
Hysterectomy data
Population data
Duplicates
• Perform data queries
• Perform system administration
• Provide electronic histories to cytology
laboratories
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Electronic Transmissions
from Laboratories
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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
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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
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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)
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Database Linkages
• Cytology Laboratories (electronic
transmission)
– PHIA compliant
– Results
– CPSM MANQAP Quality Standards
• Manitoba Health
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Population
Administrative Databases
MIMS
DPIN
• Cancer Registry
• Future Pathology Laboratory Linkage
through E-Path (AIM)
www.everytwoyears.ca
Support & Maintenance
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CCMB Health Information Services
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MCCSP Team
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Project management/application support and development
System administration
Database management
Hardware maintenance for Cytology laboratory systems
Electronic linkage (Transmed)
Program management
Data entry
Quality assurance
Development of Requests for Change
User acceptance testing
Artificial Intelligence in Medicine (AIM)
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Upgrades
New developments
Support for Laboratory Data Interface Improvements at
laboratories
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Support & Maintenance
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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
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Upgrades and Change
Requests
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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
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Information Utilization
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Operations
Surveillance/Monitoring
Recruitment and Promotion
Evaluation
Research
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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
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High Grade Abnormal Results (January 2003)
Low Grade Abnormal Results (April 2006)
Letters to health care providers
Letters to women
www.everytwoyears.ca
Surveillance
• Screening patterns by
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Age
RHA
FSA
Time
• Abnormal Pap test management and follow up
• Workload
– Cytology
– Colposcopy
– Provider
• Impact on participation, abnormalities, cancer
incidence
www.everytwoyears.ca
Recruitment and
Promotion
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Definition of eligible population
Recruitment letters
Reminder letters
Target populations and
communities
• Pap Test Learning Module
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Evaluation
• Reaching target populations
• Statistical reports
• Pap Clinic Week
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Research
• Cancer incidence and screening
participation
• HPV Pilot Study (2006)
• HPV Surveillance (2008)
• Pap test utilization and impact of
recruitment letters (2010)
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Future Questions
• Manitoba Cervical Cancer Screening Program
– 788-8627
– 1-866-616-8805
– [email protected]
• EveryTwoYears.ca
• TellEveryWoman.ca
• Women can call for copies of their own results