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Casefinding

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Casefinding Presentation Transcript

  • 1. CASEFINDING Debra W. Christie, MBA, RHIA, CTR, CCRP Director, Cancer Research & Data Center University of Mississippi Medical Center
  • 2. Casefinding
    • Systematic process to identify all cases eligible to be included in the registry database
    • Includes both inpatients and outpatients
    • Required at all types of facilities
    • Need an up to date Reportable List
  • 3. Reportable List
    • Include all malignancies (carcinomas, sarcomas, melanoma, leukemia, lymphomas
    • Benign brain tumors (must be reported as of 1/1/2004)
    • Cases reportable by agreement (ACOS hospital cancer programs)
  • 4. What Should be Reported in Mississippi?
    • Analytic cases diagnosed on or after January 1, 1996
    • Cases that were diagnosed and/or treated at your facility (on or after 1/1/96)
    • Pathology only cases read by pathologists must be reported
    • Nonanalytic cases – submit when requested by MCR
  • 5. Additional Cases to Report
    • Squamous intraepithelial neoplasia grade III of the following:
      • Vulva (VIN)
      • Vagina (VAIN)
      • Anus (AIN)
    • Refer to the state reportable list
  • 6. Mississippi - Do Not Report
    • History of Cancer Cases
    • Basal cell and squamous cell carcinomas of the skin
  • 7. Types of Casefinding
    • Active casefinding
      • More thorough
      • More accurate
      • Costs more
    • Passive casefinding
      • Self reporting less reliable
      • Dependent on others to ID cases
      • More likely to miss cases
  • 8. Casefinding Sources
    • Methods vary by individual facility
    • Depends on services offered at facility
    • Multiple sources needed to identify all cases
  • 9. Casefinding Sources Continued
    • Pathology, cytology reports
    • Admission/discharge documents
    • Disease indices/coding reports
    • Surgery schedule
    • Nuclear medicine logs
    • Radiation treatment logs
  • 10. Casefinding Sources Continued
    • Hematology or Oncology clinic appointment schedules
    • Bone marrow reports
    • Mammography reports
    • CT/MRI reports
    • Autopsy reports
  • 11. Pathology & Cytology Reports
    • >90% of cases
    • Review copies reports
    • Computer generated listing – specify codes
    • Outside cases reviewed by pathologist
  • 12. Admission/Discharge Documents
    • Daily or weekly review
    • Can be done at time discharge records processed
    • May be a computer generated list of patients
  • 13. Admission/Discharge List
    • Name MR # Serv DcDate ICD-9 Code
    • L name, 7777 Med 9-1-05 174.9
    • First
    • Sort according to your specifications
  • 14. Disease Indices/Coding Reports
    • Run monthly, depending on case load
    • May be hard copy or electronic
    • Based on cases coded
    • Obtain from health information management/medical record department
  • 15. Disease Index – October 2005
    • Name MR# DCDate PrimDx SecDx
    • Jones R 88888 10/15/05 174.9 197.0
    • May S 77777 10/18/05 V58.1 162.4
    • Wade W 11111 10/09/05 185
  • 16. Surgery Schedule
    • Type of procedure
    • Examples
      • Modified radical mastectomy
      • Radical prostatectomy
    • Especially important for outpatient surgery centers
  • 17. Nuclear Medicine Log
    • Bone scans
    • I-131 treatment for thyroid cancer
  • 18. Radiation Treatment Logs
    • Patients treated with radiation
    • Patient may have been diagnosed elsewhere
    • Patients may be included with disease index/coding list (need to know how coding is handled at facility)
  • 19. Hematology or Oncology Visits
    • Hematology or Oncology clinic on site
    • Patients may not be admitted to hospital
      • Chronic lymphocytic leukemia
      • Polycythemia Vera
    • Diagnosis by CBC or other blood test
  • 20. Bone Marrow Reports
    • Report may be generated by pathology or hematologist
    • Leukemias, myeloproliferative disorders, other malignancies
      • Chronic lymphocytic leukemia
      • Refractory anemia
      • Lymphoma involving the bone marrow
  • 21. Mammography
    • Abnormal mammograms
    • Work with radiologists to identify cases that fit criteria for cancer diagnosis (i.e., compatible with, suspicious, probable for cancer – see reportable list)
  • 22. CT & MRI Reports
    • Clinical diagnosis of cancer
    • Benign brain tumors
      • Pituitary adenoma
      • Meningioma
    • Brain metastasis
    • Work with radiologists to identify cases that fit criteria for cancer diagnosis (i.e., compatible with, suspicious, probable for cancer – see reportable list)
  • 23. Autopsy Report
    • May confirm primary site (unknown primary)
    • New cancer not diagnoses previously may be identified
      • Prostate cancer, incidental finding
  • 24. Casefinding – State Registry
    • Hospitals
    • Independent Pathology Laboratories
    • Freestanding Radiation Facilities
    • Physician Offices
      • Hematology/Oncology
      • Dermatology
      • Urologist
      • Neurologist
      • Radiologist
  • 25. Casefinding – State Registry
    • Outpatient Surgery Center, freestanding
    • Hospice
    • Nursing Homes
    • Death Certificates
    • Others?
  • 26. Review/Link Identified Cases
    • Compare site in registry database – new versus prior malignancy
    • Identify subsequent malignancies
  • 27. Enter Patient in Suspense File
    • Cases that are potentially reportable
    • Cases that need to be abstracted
    • Include - Name, Identifier, Date of first contact/Diagnosis Date, Primary site
    • File/sort by date identified
  • 28. Monitor Casefinding Completeness
    • Quality control function
    • Maintain a casefinding log
    • Review number of cases by month
    • Review number of cases by casefinding source
    • Look at primary site totals
  • 29. Casefinding Audits
    • Completed by State Registry or other entities
    • Assess completeness of casefinding
  • 30. Summary
    • Casefinding is an important procedure to identify cases
    • Identify facility specific methods to identify cases
    • Monitor casefinding for quality control