A current client\'s case study

1. AT A GLANCE Cancer Registry Services
CHRISTUS Spohn Cancer Network Texas hospital outsources cancer registry to get up-to-date
Corpus Christi, TX and stay current
Facilities
• CHRISTUS Spohn Cancer Cancer Registries: Often Overlooked, Rarely Caught Up
Network Cancer registries are an area within healthcare that is often overlooked by information
Memorial systems vendors and internal hospital information technology (IT) departments.
Shoreline
South
The registry is typically bypassed during electronic medical record implementations
• CHRISTUS Spohn Hospital Alice and document management system evaluations. However, registries are important
• CHRISTUS Spohn Hospital areas within any healthcare organization, particularly where high volumes of cancer
Beeville patients are involved.
• CHRISTUS Spohn Hospital
Kleberg
What is Cancer Registry?
Location A cancer registry includes explicit data on cancer patients that is collected as an
abstract from the medical record. The data is used to evaluate practice patterns,
CHRISTUS Spohn Health System
is a six-hospital network spanning outcomes, and survival rates on the local, regional, and national level. To do this,
13 counties across South Texas data must be collected longitudinally, over time. Certified registries, certified by
and the region’s largest not-for- the American College of Surgeons’ (ACoS) - Commission on Cancer, are used to
profit charity care provider. consolidate data at the state level and then into a national cancer database. For these
databases to be useful, there must be at least a 90% follow-up rate on cancer patients
Employees annually. The national database is monitored by the Centers for Disease Control and
4,000 Prevention, which establishes federal guidelines that each state’s central repository
must follow. Each state may also have guidelines specific to that state. It was because
Patients of a new state guideline that CHRISTUS Spohn Health System Cancer Center was
Treats more than 4,100 inpatients forced to evaluate and find a solution for its program.
and 43,300 outpatient visits
annually. State Regulations Force Backlog Cleanup
CHRISTUS is a six-hospital system with three community hospitals centrally located
Solution in Corpus Christi, Texas and three small rural hospitals across South Texas. The
TrustHCS - Cancer Registry three community hospitals have an ACoS accredited community hospital cancer
Services program. Collectively, they receive 1,800-2,000 new cancer cases every year. By Texas
regulation, these cases must be abstracted to the state registry within six months of
diagnosis. CHRISTUS Spohn had a backlog of approximately 18 months. The backlog
was due to the shortage of Certified Tumor Registrars (CTRs) in Texas. The CTR
shortage is a problem faced by many states. For CHRISTUS, the problem was further
exacerbated by workspace constraints. In Texas, if you are not compliant with the six-
month window, the state performs the abstracting function for you at a very high cost
rate. The state will also charge travel expenses for their own CTRs. These were two
costs that CHRISTUS wasn’t willing to absorb.
877.686.1123
www.TrustHCS.com
info@TrustHCS.com

2. A Plan-of-Action: Registry Out-Tasking
The solution to the problem was to get people to handle the backlog and to allow these people to work
from remote locations. Tim Osterholm, MPA, Executive Director of Oncology and Imaging Services and his
team looked at several vendors to do the job. TrustHCS was chosen as the organization’s cancer registry
partner. TrustHCS performed cancer registry remotely, thereby eliminating travel and lodging expenses
with no space requirements for its CTR staff. Osterholm viewed the ability to perform the case reviews
and abstracting from a remote location as the only way to go for CHRISTUS. Even if Osterholm and his
team had found CTRs in Corpus Christi, there was no space for them to work.
Remote Cancer Registry - It Works
With TrustHCS Cancer Registry Services, the CHRISTUS Spohn team identified the new cancer cases
and pulled all necessary medical record information for the case. The documents are scanned or
electronically fed into a work queue within TrustHCS’s web-based system. From there, the TrustHCS CTR
team viewed the information and performed the abstracting function. Of course, security is paramount
and maintained along with complete audit trails at all levels. Within four months, the TrustHCS team
completed 90% of the backlogged cases. The remaining 10% was done within a month’s time. Maggie
Salinas, CRT and coordinator of CHRISTUS Spohn Cancer Registry states, “The partnership with TrustHCS is
really smooth and working great.” Once finished with the backlog, the contractual relationship continued
to allow the current year’s abstracts to be completed and the registry to stay up-to-date as new patients
are diagnosed. In 2008, CHRISTUS Spohn Hospital received full approval with commendation from the
Commission on Cancer. TrustHCS’s contribution to the CHRISTUS program helped the organization
achieve a perfect quality of data submitted to the National Cancer Database. Maggie Salinas stated,
“This could not have been accomplished without the superior service and dedication that has remained
constant throughout our alliance with TrustHCS.”
Cancer Registry Takes Center Stage
The updated registry at CHRISTUS Spohn is used to identify local and regional trends, create annual
reports, feed the state registry, and ultimately provide Texas information for national statistics. According
to Osterholm, registry information is also used by CHRISTUS executives and clinicians as follows:
• Strategic planning reports guide what new services should be provided.
• Out-migration studies identify when and why patients pursue follow-up cancer treatment at
other facilities.
• Volume data justifies new capital expenditures to treat cancer patients.
• Survival data helps identify and establish best practices guidelines.
• Outcome information measures efficacy of various protocols and physical performance. In conclusion,
Osterholm emphasizes the importance of keeping the registry up-to-date and accurate. He concludes,
“Registry data is just too important to be left behind. If the information is old, it loses its value to our
executives, our clinicians, and ultimately the patients we treat.” Can cancer registries cure cancer?
No, but they can help!
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