Part 3 of a multi-part series on cancer surveillance and data collection in the United States.
Cancer Registries are staffed with Cancer Registrars who have met the stringent and complex requirements for education, training and work experience. While some Registries have non-credentialed staff who perform administrative tasks or are in training for their credentialing exam, most Registrars are certified tumor registrar’s, or CTRs. Only CTRs can abstract from the medical record cancer information that is reported and used for statistical and quality studies.
There are several processes, or phases, to cancer data collection and reporting. It starts with casefinding, or identifying the people with cancer who have been diagnosed or treated at the hospital or other medical facilities. Most patient’s start their cancer journey with a visit to their primary care physician (or PCP) and are then referred to specialists who will diagnose and recommend treatment for their specific type of cancer.
“Casefinding is like casting a net far and wide to “capture” all the reportable cancer cases.” (1)
CTRs look at the medical record and through manual or automated processes enter the cancer site, histologic type, patient demographics (such as gender, race or age) and the extent of disease (or the stage) into the case abstract. Some Cancer Registries will collect additional medical and scientific data elements, such as the type of treatment, and then follow the patient each year to track any reported recurrence and lifetime survival.
(1) Surveillance, Epidemiology and End Results (SEER), National Cancer Institute
Part 2 of a multi-part series on cancer surveillance and data collection in the United States.
Cancer data is collected in the USA by a system of registries. Data collected depends on the purpose of each registry and there are two primary types:
Hospital Registries, usually a department in a hospital, cancer center or medical facility.
Population-based Registries, typically found in state health department or government agency.
Hospital Registries provide hundreds of data elements, some of which are quite complex, that is used to study and evaluate the patient care process given within the hospital. Hospital-based data is focused on things like the care of the cancer patient (from diagnosis, treatment and on to lifetime follow-up) to educating the healthcare providers. If a hospital is part of a system or affiliated group of hospitals they may pool their data and use the collective information to learn more about how the different types of cancers respond to the care given system-wide. Pooled data can be used in studies to compare trends or patterns of care, demographic or population subsets or by geographic region.
Population-Based Registries are often a part of a state, or even national, health department system. They collect the information on all cases diagnosed within a certain geographic area. They also pull together information from the reporting facilities within their geographic region that may include, but is not limited to:
Hospitals,
Doctor’s offices,
Nursing homes,
Pathology laboratories,
Radiation and chemotherapy (infusion) treatment centers,
Ambulatory care facilities or clinics,
Or other cancer care facilities.
Population registries use this larger pool of data to study new cancer cases (or incidence) and death rates (or mortality) in the regions across the United States. Population-based registries can look at cancer rates in certain types of jobs or groups of people, and see if the cancer survival is improving or not in each group. They can also watch trends over time to find out if the rate of a certain type of cancer is increasing or declining over time. Lastly, they can monitor the incidence or mortality rates in age or ethnic groups to see who is most affected by different types of cancer. One example of this type of analysis is published in the Cancer Facts & Figures each year by the American Cancer Society.
Information also reported by hospital-based and population-based registries helps to guide local, regional and national cancer prevention and control programs that focus on changing certain behaviors (like smoking), lifestyle (like healthy eating habits) or environment risks (like asbestos exposure). The data from a cancer registry helps to identify a specific need for increased cancer screening (like lung cancer screening) in a certain region or area.
Published in: The Baltimore Sun / Reuters, May 8, 2013
NEW YORK (Reuters Health) – Professional medical societies don’t often consider costs when they’re developing their treatment guidelines for specific conditions, according to a new study. Researchers found that just over half of the top medical societies with at least 10,000 members considered costs when developing best practices. The other half either implicitly considered costs or didn’t address them at all. “Even when they said they looked at costs, they didn’t seem to have a clear, consistent or rigorous way to do so,” said Dr. Steven Pearson, the study’s senior author and a visiting scientist in the Department of Bioethics at the National Institutes of Health in Bethesda, Maryland.
Congratulations to all the National Cancer Registrar’s Association (NCRA) 2011 award winners! Awards were given at the 35th Annual Education Conference held in Washington, D.C., in April, 2012.
On Tuesday, May 22, 2012 Registry Mindset was pleased to sponsor the first Cancer Registry Leadership Mentoring Group. Members on the call will participate in monthly calls and webinars to grow the leadership skills of each member as well as those of cancer registrars around the world.
Vision Statement: We envision a future where every cancer registrar:
Has the mindset, skills and resources needed to consistently achieve successful outcomes as effective leaders.
Is empowered to enthusiastically explore new leadership opportunities that support advances in cancer registration, science, medicine and quality control.
Is engaged in a culture of mentoring other cancer registrars, and
Influences his/her team to achieve excellence in oncology healthcare.
If you, or another cancer registrar would like to join this dynamic, forward-thinking group of cancer registry professionals click here and sign-up today!
Cancer Registrars have been using ICD-10 mortality codes for some time and we are familiar with coding and standards changes. But, what is the “inside scoop” on why are ICD-9 codes are being replaced? Here are some quick facts on what is happening in the industry.
ICD-9-CM is a diagnostic and procedural classification system originally developed in the 1970’s. As you might expect, its use has surpassed the original design and ICD-9 is no longer effective. It simply cannot be stretched or updated any further to support 21st century medicine and healthcare.
United States is the only industrial nation that has not upgraded its morbidity classification system. By upgrading to ICD-10 we will improve our ability to monitor and respond to international health events, increase the value of theUS’s investment in SNOMED-CT®, and help provider organizations to achieve better benefits from the electronic health record (EHR).
Briefly, ICD-9:
Does not have adequate specificity and detail.
Is running out of capacity and its limited structural design cannot accommodate new advances in medicine, medical technology, or the rapidly growing need for quality data.
Is obsolete and no longer reflects current knowledge of disease processes, medical terminology or 21st century practices of medicine.
Impedes the use of a standardized system needed to compare costs and outcomes from different medical technologies and specialties.
Cannot support theUnited States’ transition to an interoperable health data exchange format.
In summary, replacing the ICD-9 system with ICD-10 will help us to better maintain clinical data comparability with the rest of the world regarding conditions and diseases that require healthcare services. ICD-10 makes it easier, and this directly affects cancer registrars, to share disease and mortality data during these critical times for public health.
Cancer Registrars are already asking what the “ripple effect” will be for them. The answer is simple, we don’t know yet. Perhaps there will be change, but until ICD-10 is fully implemented the cancer registrar would be better served by developing an understanding of what is needed to analyze and report accurate and quality data in the 21st century and adopting a mindset that welcomes expanded use of cancer registry data and patient care outcomes.
To learn more about ICD-10 visit the American Health Information Management Association (AHIMA) website by clicking here. Check back to our website for future posts about what is happening with ICD-10 and other planned training events such as webinars, white paper summaries and more.
If you find this post helpful, add a comment below and tell us why!
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Michele Webb creator of http://www.RegistryMindset.comthe cancer registrar’s best online resource, is a nationally recognized, certified cancer registrar, committed to Cancer Registry leadership and professional education as a coach, mentor, motivational speaker and author. You have permission to repost this article as long as do not alter it in any way and give a link back and credit to the author and this URL.
How has your day gone so far? If you are like many people you went about your business today with some ups, and some downs. For some it may have been worse, or perhaps even better. Shaping our world is something that we CAN and should be doing. Nothing should be left to chance or placed in the hands of someone else. Gary Lew said this so well, “This is your world. Shape it or someone else will.”
We have the power and ability within ourselves to not only shape our world, but to create a life that is beyond our wildest dreams and imagination. We are not saddled with what someone else expects of us. One only has to look at the Special Olympics, or other people that have overcome significant hardship or challenges to do something great. So, why is that so many people, with the world at their fingertips and so many blessings and gifts in hand, can’t make a go at success or happiness?
Joel Osteen, in his book Your Best Life Now: 7 steps to Living at Your Full Potential, said, “You must make a decision that you are going to move on. It won’t happen automatically. You will have to rise up and say, ‘I don’t care how hard this is, I don’t care how disappointed I am, I’m not going to let this get the best of me. I’m moving on with my life.”
Each of us has potential and the God-given choices abilities to use that for something great. How we go about it, or how we shape our life to use these resources is entirely up to us. Cancer Registrars can easily get overwhelmed with rules, changes, guidelines, coding requirements and the constant change and shifting that is happening in healthcare today. But, even with all that, they can rise above it and change their world.
So, how are you shaping your world today? What do YOU do that makes a difference? What do YOU do that keeps you going no matter what? Please share with us your tips and secrets. It is by sharing and helping one another that we grow.
In closing, consider this statement by Maria Shriver, who I think is an excellent example of someone who has risen above the fray many times. “Make the job a reflection of you, as opposed to you trying to fit into the job.” Cancer Registrars, does your work reflect well of you or are you swimming in self-doubt? Are you bringing your expertise to the table to meet the organization’s business need, or are you slumped back in your chair waiting for someone to come to you? Are you using your skills, talents and worth to shape and serve your world?
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Michele Webb creator of http://www.RegistryMindset.comthe cancer registrar’s best online resource, is a nationally recognized, certified cancer registrar, committed to Cancer Registry leadership and professional education as a coach, mentor, motivational speaker and author. You have permission to repost this article as long as do not alter it in any way and give a link back and credit to the author and this URL.
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