NPCR-AERRO Analysis and Design

NPCR-AERRO analyzes current technology and infrastructure surrounding cancer registry operations based on the AERRO models and design specifications for the development of products to support automation and electronic reporting. Results of analysis and design may lead to functional specifications or feature enhancements for registry software, implementation guides, class diagrams, white papers or gap analyses, and identified standards.

Methods

The Technical Development team collaborates with workgroups and other subject matter experts to—

• Create guidelines to implement models for electronic reporting and automation.
• Develop data element requirements and class diagrams.
• Develop standards where needed, based on models.
• Evaluate available technology and identify gaps based on models.

Note: Please see the Glossary [PDF-777KB] for definitions of technical terms.

Activities

eHealth Initiatives

• Integrating the Healthcare Enterprise (IHE).
  • Developed IHE profiles to demonstrate data exchange between 1) pathology laboratories and central cancer registries, and 2) physician offices/EHR systems and central cancer registries.
  • Collaborated with the IHE Pathology Domain, hosted in Europe, and NAACCR to harmonize the HL7 v.2.5.1 pathology specification to meet the needs of cancer registries in the United States.
  • Worked with the IHE Pathology Domain to write a white paper that addresses the implementation of protocols for the CAP Cancer Checklists or discrete data elements (structured/synoptic reporting).
• Council of State and Territorial Epidemiologists (CSTE). Participate in developing a CSTE Position Statement for Cancer that fully describes what is reportable to the state and national levels.
• Health Level 7 Public Health and Emergency Response (HL7 PHER). Participate in this group to ensure that the cancer registry community’s requirements are met.
• Health Level 7 Anatomic Pathology Workgroup (HL7 AP). Participate in this group to ensure that cancer registries’ data needs are met.

Electronic Pathology (ePath) Reporting

• Text mining/natural language processing. Analyzed different technologies available for text mining that may increase the accuracy of cancer case identification. These technologies were integrated into eMaRC Plus, the CDC software developed for use in the ePath Pilot Project.
• Autocoding/computer-assisted coding. Explored options for electronically assigning ICD-O-3 codes for primary site and histology to be validated by registrars and designed eMaRC Plus to include this autocoding.
• Mapping eCCC data elements to required NAACCR standards. As the electronic CAP Cancer Checklist (eCCC) becomes more widely used by pathologists around North America, it is necessary to map data from the eCCC to NAACCR data items. This activity is important for future implementations of the eCCC to ensure that cancer registries can convert eCCC data to the standard NAACCR format.

Clinic/Physician Office Reporting

• Identified functional needs of central cancer registries to receive and process clinician data.
• Identified appropriate data elements to include on clinician reporting form.
• Identified IHE profiles and transactions that may be applicable to the use case. Examples to review include—
  • IHE Request Form for Data Capture
  • IHE Retrieve Protocol for Execution
• Modified existing and where needed developed new standard formats using the IHE constructs and other relevant eHealth Standards that are consistent with NAACCR standards, and presented them to NAACCR for consideration.
• Identified and evaluated use of vocabulary standards and tools for vocabulary access and distribution (e.g., PHIN VADS, caDSR, Canada Health Infoway).
• Identified and evaluated existing standards for exchange of clinical data (e.g., HL7 CDA, security standards).
• Identified and evaluated tools for secure data exchange.

Central Cancer Registries

Visual editing. Designed a standard methodology to identify the appropriate number of cases that should be visually edited and reviewed by a certified tumor registrar. Converted this methodology into a computer-based tool to calculate sample size based on total case number, thereby decreasing the actual number of cases for which manual review is necessary.

Hospital Operations

Data transmission standards. Analyze and design specific data source formats (such as discharge summaries) and file structures for electronic data transmission to the hospital registry.