IMPAC on Registries in Australia – Melissa Carson


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  • Overall view of Précis architecture .
    Summarize the information here:
    Main points to address:
    four modules
    user-definable options
    easily updated
    automatic processing
    streamlines user workflow by consolidating separate functions
  • This slide gives a graphic idea of Précis’ flexibility of input and output. Beginning at 9:00 in the graphic,
    Input sources may include manual data entry as well as imports from hospital information systems, Multi-ACCESS radiation and medical oncology , and PowerPath Pathology System* (Pending).
    Outputs include predefined and ad hoc reporting (emphasizing a wide variety of outcomes and survival analysis methods), central state reporting, American College of Surgeons Commission on Cancer’s required annual call for data into the National Cancer Data Base
    Scheduling of Follow-up actions including chart review listings, letters, faxes, emails, telephone contact lists
  • IMPAC’s registry management system supports the download of data directly from the EMR, extensive reports and flexible ad hoc querying capability, and the ability to compare center statistics with benchmark data provided by IMPAC’s Oncology Data Alliance (ODA).
    IMPAC leading hospital and central cancer registry systems support the collection and reporting of cancer cases in accordance with all national and ACoS (American College of Surgeons) requirements.
    As an integral part of our spectrum of care, they also benefit from automated case finding and electronic download of data from IMPAC’s oncology EMR.
    IMPAC’s National Oncology Database (NODB) currently consists of more than 1.8 million cancer cases occurring throughout the United States from 1985 to the present and is updated monthly by our registry customers. The NODB is available to IMPAC customers for benchmarking and academic research.
  • How do we compare with other central registry vendors in the market? Here’s the proof.
    NOBODY has user defined case consolidation
  • Précis is a full-featured registry and data management system that simplifies the process of data collection, analysis, and reporting. The system is designed to be intuitive and efficient, speeding the registrar through collection of data using probabilistic matching algorithm and advanced consolidation tools. Précis has the ability to conduct in-depth analysis of this collected data by utilizing predefined and user-defined reporting capabilities. And, to complete your cancer registry needs, Précis provides substantial tools to aggregate data and enhances your ability to track cancer cases.
  • Faster abstracting: Easy to abstract directly into the application or import files from other sources
    Faster validation: utilizes GenEDITS engine and metafiles – standard metafiles from state/national sources plus user editable metafiles
    Customizable database: Administrative users can add database items and synchronize database without requiring customization from IMPAC
    Global updates: Users can globally update cases and records within the system based upon user-criteria
    NAACCR compliance: Meets current NAACCR standards for data management and exporting (North America)
    IARC compliance: Meets current IARC standards for data management and exporting (International)
    Online help modules: application manual online; includes ROADS, FORDS, SEER manuals plus available TNM 5th/6th editions, topography, and morphology
    Multiple import formats: Supports current NAACCR formats; User can define own import formats (specific criteria, flat files); supports pathology imports including PowerPath and Multi-ACCESS
  • Probabilistic matching: utilizes automatic probabilistic matching algorithm; matched records assigned score that determines if record is match or not a match to cases in the database (and also in the suspense database). Records with “gray area” scores automatically moved to separate pending area for visual review.
    Advanced case consolidation: system and user defined rules definition and implementation for consolidation; field level rules application; automatic consolidation with historical data that is modifiable by user
    Multiple primary rules: supports both SEER and IARC multiple primary rules
    Case comparison: side by side comparison of records and cases to determine match for “gray area” results
    Death Clearance: supports identification of death clearance abstracts and letter generation to facilities or practitioners
    Linkages: supports linkages data including death certificates, motor vehicle records, voter registration, pathology, and other sources
  • Export manager:
    Advanced exporting: The new advanced exporting features enable you to set filters for selection of records/cases, process temporary edits and make updates, and export through a user-friendly interface. You can now export cases from batch edits after a filter is given. The filters are very similar to those used in the Reports module. You can also select and export a fixed number of test cases.
    Utilizes data fields as filters to identify groups of records or cases for export. Current NAACCR export formats supported
    User-defined export formats (classic exports): Supports user defined flat file export formats (specific criteria required)
    Report manager:
    Pre-defined reporting on cases and records: standard lists, frequency tabulations, cross tabulations, survival, quality monitoring, NAACCR reports
    Ad hoc reporting tool utilizing all data fields as elements filters
    Exports reports in multiple formats with email or application coordination as desired
    Filters: all data fields available as filters in addition to calculated special filters
    Report log documents all reports generated from system
    Meets HIPAA standards for documentation, security, tracking
  • Integration: Multi-ACCESS (Med Onc, Rad Onc), PowerPath
    Case ascertainment – assists in finding all cases of cancer
    Integration and data import decreases amount of data needed to be manually entered
    Manual data collection tool for direct data entry into viewer or directly into database (suspense or central)
    Integration of data from outside sources – non-IMPAC systems including pathology, other facilities, other databases
    Flexible user defined system
    No other system allows users to add to database, resynchronize database, create own import and export formats
    Sophisticated case consolidation system – allows field by field rules application, user defined rules definitions, system consolidated fields – available in no other system
    Meets needs both North America and International
  • Fast, intuitive visual review and record disposition
    Users can determine how much or little of the automation to utilize when importing and consolidating records
    Side by side comparison of records and cases and ability to edit/transfer data by field between records
    Computer suggested case disposition for pending cases – easy to accept the disposition or over-ride it
    Ability to restructure records and cases at any time, and at all levels of record
    Maintains source records in tree format
    Decision making streamlined:
    Using pre-defined and ad hoc tools to easily generate reports and data for analysis
    Export data to other analytical systems (i.e., SPSS, SAS)
    Utilizes Crystal reports engine with front end GUI for ease of use
    Standards NAACCR submission and completeness reports included
    Structured implementation program and implementation team with project lead
    Database flexibility
    Includes web based and on-site training program with additional training easily added to contract
    Includes detailed training schedule
    Support team:
    Includes CTRs (certified tumor registrars) with experience in hospital and central registry facilities; development engineers with expertise in application programming and central registry requirements, quality testing engineers working with team to provide optimal system, support technicians to assist in implementation and ongoing support
    Expert, high Quality data conversion: Conversion of standard NAACCR files and non-NAACCR files, with import into application. Provides up to three reviews of data conversion for acceptance
  • These bullet points summarize some of the major advantages of the product. You’ll see more details on each in the upcoming slides.
  • Case finding can be one of the most time consuming drains on registry resources. Précis-Hospital can streamline this process by downloading demographic, clinical and tumor-specific details from multiple sources.
    In the top screen print you see the “home” screen where existing cases can be listed. Clicking an Import button on the right initiates the download of information from another system into Précis-Hospital.
    In the bottom screen print on this slide you see a red area – this is the result of comparing fields from two separate records on the same patient or tumor. The red lines indicate fields where data elements are different (for example a different date of last contact). Fields can be updated in the existing record can be updated by a simple click and drag.
    Information on new cases and updates to existing cases can come from
    1. Importing any NAACCR formatted records file
    Downloading information from hospital systems
    Accepting information from the IMPAC’s PowerPath Pathology System or the Multi-ACCESS medical and radiation oncology systems
    Future enhancements include the automatic import of treatment information as well.
  • Abstracting flows in the same manner as the typical medical record. The red fields are required either by NPCR OR the ACoS CoC. Each field has an arrow beside it to bring up the lookup.
    Edit checking uses the national standard GenEDITS engine, allowing the user to add, select and delete edit sets at will.
    More than 100 user defined fields allow the user to customize the data set, giving unique names to fields and creating user-defined lookups
    The system offers nearly 20 site specific data sets including all those involved in American College of Surgeons Commission on Cancer site specific studies. The user can collect a selection of these items with future research projects in mind.
    Queries can be initiated at the “home page” Master Patient Index (MPI) screen for simple frequency counts, or from the extensive reports module of nearly 100 predefined reports. Ad hoc reporting is available using Data View where any field in the abstract can be used to select cases pertinent to the study and to display selected data items on those cases. Reports can be directly printed, graphed, emailed or exported to Excel, Adobe Acrobat and other formats.
    The system meets requirements from state, provincial, national and international standard setters. Numerous enhancements have been added to allow users flexibility in meeting HIPAA recommendations for security and confidentiality.
    On-line help includes the standard references such as those from the College of Surgeons Commission on Cancer (ACoS CoC), American Joint Committee on Cancer (AJCC), the NCI’s Surveillance Epidemiology and End Results (SEER) program, and ICDO-3 site and histology coding schemes. Précis-Hospital Help also includes descriptors and rules for coding every field, an extensive How To module and even links to websites of all the standard setters.
  • Follow-up is a big commitment toward running a successful registry. It requires following every patient at least annually for the rest of the patient’s life. Thus, the older your registry, the bigger the commitment. Without follow-up, outcomes can’t be measured. So Précis-Hospital makes it easy.
    Case management is enhanced by historic documentation of an unlimited number of follow-up efforts – updating follow-up is easy – recurrence and treatment information is simple to add
    The bottom screen print contains a control list which shows each action for every patient who is due for follow-up during a user-selected time period. The list can be grouped and sorted by any column header.
    Templates are available to make an unlimited number of letter, fax or email formats available
    Additional templates can be used to insert an entire series of scheduled actions to follow one or a group of patients
    Updates to individual patient records can be made directly from this screen
    With the click of a button, whole batches of letters can be generated or telephone contact lists or chart pull lists can be printed
    The click of a button in the patient’s record can initiate a search of the Social Security Death Index data base to determine whether a patient has expired.
  • Reporting from Précis-Hospital allows intuitive analysis of patterns of care and their outcomes.
    There are over 100 pre-defined reports which can be automatically formatted for Word, Excel, Adobe Acrobat, HTML, rich text, XML and others. They can be sent to a disk file, e-mail or another application such as Excel. They can be printed or sent to a fax machine. Bar graphs are automatically generated for all frequency and cross tab reports. Line graphs are automatically generated with each survival calculation.
    Ad hoc reporting allows unlimited selection of data items as filters for the population under study and as column headers in the report. The user can sort or group by any column header and there are multiple formatting options like orientation, margins and adding titles, subtitles, headers and footnotes. Ad hoc and pre-defined reports can all be logged with extensive accompanying detail if desired.
    Filters for the population can include all fields of the abstract, along with a number of calculated fields such as age range, survival time, first course of treatment summary and primary site groups.
    Multiple reports include standard master patient indexes, summaries of patients with multiple primaries, patients by doctor, primary site tables, survival calculations and graphs, data quality control reports and reports designed to assist in preparation for Commission on Cancer survey.
    Voluntarily electing to share de-identified data with IMPAC’s National Oncology Data Base (NODB) gives the user access to benchmarking against a verified 2 million+ case data base.
  • Users may elect to do their own submissions to state, provincial, national central and other governmental registries. Or they may also elect to submit the data to IMPAC’s NODB (National Oncology Data Base) and our staff will automatically take care of the required reporting.
    An Export option allows reporting or retransmitting to one or several states and national databases automatically formatted for the reporting agency.
    In addition, any subset of cases may be selected for exporting in the standard NAACCR (North American Association of Central Cancer Registries) format.
    And finally, as we mentioned previously, you can compare your data on a subset of cases with that of hundreds of other facilities across the nation through the NODB.
  • Just to summarize some of the Advantages of Précis-Hospital…
    We can accept data from multiple other sources
    Much of the system is user-definable
    Our updates and standards keep pace with rapidly changing standards
    There is unlimited flexibility in quality control of data using any edits set that conforms to the GenEDITS standard
    We can accommodate LANs, WANs, and Citrix connections for offsite workers
    Smaller registries can use MS-Access and SQL is recommended for medium to large registries – multiple facilities can elect to enter cases into one or an unlimited number of databases
    A large optional dataset enhances potential for research using the database
    We have more than 30 Certified Tumor Registrars (CTRs) on staff as well as skilled technical support specialists
    Our data conversions are managed by CTRs and are one of our highest quality services
    We have a reputation for bringing out updates based on new standards in a timely fashion
    An ASP option is available for those who don’t wish to host the application on their own hardware
    We provide an entirely electronic solution to registry data management needs
    We are the largest registry provider in the world!
  • Victoria data set – screen view
  • Shows levels of information – with demograhic, two primaries, multiple source records imported per primary including pathology information.
  • IMPAC on Registries in Australia – Melissa Carson

    1. 1. IMPAC and Registry Data Bases IMPAC Medical Systems An Elekta Company
    2. 2. BIG PICTURE National Data Aggregation National Data Aggregation Central Registries Central Registries Hospital Registries Hospital Registries LabsLabs OISOISHISHISLabsLabsHISHIS OISOIS DREAM ?DREAM ?
    3. 3. Précis-Central Central Data Management for the 21st Century Pending Pending Central Registry Suspense Dictionary Dictionary AdministratorAdministrator Linkage Files Linkage Files Exports Exports Reports & Analysis Reports & Analysis Previewer Previewer Validation Validation Visual Editor Visual Editor Validation Validation Import Match Consolidate Import Match ConsolidateRecords Records Data Entry Aggregation Analysis & Reporting W.H.O
    4. 4. Précis™Précis™ Follow-up Schedule and Actions Follow-up Schedule and Actions Data analysis & reports State Central reporting Call for Data PowerPath™ Précis-Hospital National Data National Data
    5. 5. Managing the Spectrum of Cancer Care Analysis Outcomes Reporting Anatomic Pathology Diagnosis Treatment Oncology Care Cancer Registry Survival
    6. 6. Introducing IMPAC IQ* ANALYTIQ Data Aggregation Analysis & Reporting Anatomic Pathology Information System DIAGNOSTIQ MOSAIQ Image-Enabled Oncology EMR Cancer Registry Data Management METRIQ
    7. 7. IMPAC Précis-Central Comparison Hospital and Central Registry Integratio n with EMR Pathology Interface Integrated GenEDITS National Comparative Database Remote Access and ASP Probabilistic Matching User defined import, export, consolidation Précis- Central √ √ √ √ √ √ √ √ ERS √ √ C/Next √ √ OncoLog √ AIM √ Rocky Mountain √
    8. 8. Précis-Central Product Overview • Full featured central data management system • Simplifies and streamlines – Data collection – Data aggregation – Data analysis • Promotes data integrity – Industry standard validation checks – Probabilistic matching and advanced case consolidation – Pre-defined and user-defined reporting and analysis
    9. 9. Précis-Central Data Collection • Faster Abstracting and Validation • Customizable Database • Global Updates • Standards Compliance – NAACCR – IARC • On-line Help Modules • Multiple Import formats – Multi-ACCESS/ MOSAIQ™ – Power Path™ – NAACCR – User-defined Import Formats
    10. 10. Précis-Central Data Aggregation • Probabilistic Matching • Advanced Case Consolidation – Standard – User defined • Multiple Primary Rules – SEER – IARC/IACR • Case Comparison • Death Clearance • Linkages
    11. 11. Précis-Central Data Analysis • Export Manager – Advanced Exporting – NAACCR Formats – User-defined Export Formats • Report Manager – Pre-defined Reporting – Ad hoc Reporting – Filtering – Report Log
    12. 12. Précis-Central Advantages • Aggregation of data from IMPAC products – Improved case ascertainment – Reduced data entry – Multi-faceted data collection tool • Integration of data from outside sources • Flexible, user defined system – Dynamic, customizable database – Sophisticated case consolidation and data aggregation – Import and export formats
    13. 13. Précis-Central Advantages • Fast, intuitive visual review and record disposition • Streamlined reporting to support decision making – Pre-defined reports – NAACCR reports • Professional implementation, education, and support team • Expert data conversion team
    14. 14. Précis-Hospital Product Overview • Full featured facility registry data management system • Simplifies and streamlines – Case finding – Data collection – Follow-up – Data reporting – Data analysis • Promotes data integrity • Flexible security options
    15. 15. Case Finding • Download patient information – Demographic Data – Clinical Data – Tumor Data • Import NAACCR records • Multiple Data Sources – Hospital Systems – Pathology Systems – PowerPath™ – Multi-ACCESS™ – Medical Oncology – Radiation Oncology Précis-Hospital
    16. 16. Data Collection • Fast, intuitive abstracting • Integrated edit checking – GenEDITS • Database flexibility – >100 User-defined data fields – Site-specific data sets • Multiple query methods • Meets standards – State / Provincial / International – HIPAA • Comprehensive On-line Help – ROADS, FORDS, SSS2000, Collaborative staging – Add on modules include: – Topography, Morphology, TNM staging Précis-Hospital
    17. 17. Follow-Up • Automatic case management follow-up • Historical follow-up maintained – Update information – Recurrence information • Comprehensive control reports • Comprehensive follow-up actions – Templated actions and letter formats – Chart, phone, fax, email, letter • Individual or batch processing • SSDI search and update Précis-Hospital
    18. 18. Analysis • Powerful outcomes inquiry • Library of pre-defined reports – Multiple export formats • Ad hoc reporting – Store filters and elements • Comprehensive filtering – Data fields – Special calculated elements • Multiple reporting options • Comparative data with NODB™ Précis-Hospital
    19. 19. Reporting • Automatic reporting to state/provincial & national central registries – Optional IMPAC managed • Export data subset Précis-Hospital
    20. 20. Précis-Hospital Advantages • Integration with IMPAC applications – Multi-ACCESS, PowerPath • Import hospital demographic data • Timely updates to meet current state, provincial, national standards • Improved quality and productivity • Accommodates small to large multi-facility registries • Rich, extensive research dataset • Professional implementation, education and support team • Quality data conversions
    22. 22. Preview Source Records – customised headers Customized data view headers for previewing incoming source records. Example specific to Australian requirements.
    23. 23. Australian Preview Source Records
    24. 24. Modifiable Data Set Shows data set specific to Australian requirements
    25. 25. Maintains Source Records and Consolidated Case Last Name, First Name, Middle Initial 00/00/0000
    26. 26. User defined comparison view Comparison View •Easy comparison of existing case with incoming source record •Color coded fields: •Red = unmatched •Yellow = missing •Note Australian-specific field names.
    27. 27. Automatic or Manual Case Disposition
    28. 28. Completing the BIG Picture MultiACCESS Connect
    29. 29. MultiACCESS Connect Product Overview • Multi-ACCESS Connect is a data integration tool designed to import demographic, tumor, and treatment data from IMPAC’s Multi-ACCESS system to IMPAC’s cancer registry systems. • Multi-ACCESS Connect – Streamlines case finding – Reduces redundant data entry
    30. 30. MultiACCESS Connect Feature Review • Filters for new cancer cases and for new information to add to established cases • Creates a NAACCR file for import into Registry • Quick, on-screen case comparisons • Drag and drop to accept new information
    31. 31. MultiACCESS Connect Advantages • Registry has instant access to new cases and case updates in MultiACCESS • Eliminate requests for patient lists from the other department • Improves sharing and integration of data between departments
    32. 32. CONTACT 0429 99 72 66 - Sales – Product Manager – Applications Specialist BOOTH 66 @ AH & MR Congress