Hassell Lewis, Aldinger Wendy, Moody Cheryl, Winters Sharon, Gerlach Ken, Schwenn Molly, Perriello Deborah
University of Oklahoma Health Science Center, Oklahoma City, OK, USA.
J Registry Manag. 2009 Winter;36(4):117-24; quiz 163-5.
Pathology reports represent a rich data source for cancer registries. The College of American Pathologists (CAP) Cancer Checklists present pathology reports in synoptic form and allow registries to be updated electronically. To assess the challenge of employing the CAP Cancer Checklists in pathology laboratories and transmitting that information to cancer registries, we conducted a pilot project: the Reporting Pathology Protocols project (RPP2). The RPP2 project was a multi-year, "proof of concept" demonstration that assessed pathology report-generated data for 3 CAP Cancer Checklists (breast, prostate, and melanoma) in several different cancer registry-pathology laboratory combinations in 3 states. Collaborating pathology laboratories and state cancer registries in California, Maine, and Pennsylvania identified key questions (queries) to address in the course of the project, developed and tested standardized HL7 messaging specifications to link senders and recipients, and then assessed the actual process results using either parallel reporting or retrospective-prospective cases for each tumor type. Successful electronic transfer and capture of pertinent data elements for numerous examples of each tumor type was accomplished in each participating cancer registry/reporting laboratory/information system combination. We noted shortcomings in the electronically encoded CAP Checklists as opposed to text-based reports, particularly for breast cancers. We uncovered opportunities to improve Checklists and the information systems that incorporate them. Workflow, productivity, and timeliness of reporting are areas where electronically encoded reports may enhance cancer registry processes. The accuracy and completeness of electronically encoded data appears largely comparable to text-based data, but subject to the degree of synchrony between the formats of text-based and electronic reports.
病理报告是癌症登记处丰富的数据源。美国病理学家学会（CAP）癌症检查表以概要形式呈现病理报告，并允许登记处以电子方式更新。为了评估在病理实验室采用CAP癌症检查表并将该信息传输至癌症登记处的挑战，我们开展了一个试点项目：报告病理协议项目（RPP2）。RPP2项目是一个多年期的“概念验证”示范项目，在3个州的几种不同癌症登记处 - 病理实验室组合中，评估了3种CAP癌症检查表（乳腺癌、前列腺癌和黑色素瘤）由病理报告生成的数据。加利福尼亚州、缅因州和宾夕法尼亚州的合作病理实验室和州癌症登记处确定了项目过程中要解决的关键问题（查询），开发并测试了用于连接发送方和接收方的标准化HL7消息规范，然后针对每种肿瘤类型使用并行报告或回顾性 - 前瞻性病例评估实际过程结果。在每个参与的癌症登记处/报告实验室/信息系统组合中，针对每种肿瘤类型的众多示例成功实现了相关数据元素的电子传输和捕获。我们注意到与基于文本的报告相比，电子编码的CAP检查表存在缺点，特别是对于乳腺癌。我们发现了改进检查表以及包含检查表的信息系统的机会。报告的工作流程、效率和及时性是电子编码报告可能改善癌症登记过程的领域。电子编码数据的准确性和完整性在很大程度上似乎与基于文本的数据相当，但取决于基于文本的报告和电子报告格式之间的同步程度。
