Florida Cancer Data System, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine.
Florida Department of Health, Bureau of Epidemiology.
J Registry Manag. 2024 Spring;51(1):41-48.
Hospital electronic medical record (EMR) systems are becoming increasingly integrated for management of patient data, especially given recent policy changes issued by the Centers for Medicaid and Medicare Services. In addition to data management, these data provide evidence for patient-centered outcomes research for a range of diseases, including cancer. Integrating EMR patient data with existing disease registries strengthens all essential components for assuring optimal health outcomes.
To identify the mechanisms for extracting, linking, and processing hospital EMR data with the Florida Cancer Data System (FCDS); and to assess the completeness of existing registry treatment data as well as the potential for data enhancement.
A partnership among the Florida Department of Health, FCDS, and a large Florida hospital system was established to develop methods for hospital EMR extraction and transmission. Records for admission years between 2007 and 2010 were extracted using ICD-9-CM codes as the trigger and were linked with the cancer registry for patients with invasive cancers of the breast.
A total of 11,506 unique patients were linked with a total of 12,804 unique breast tumors. Evaluation of existing registry treatment data against the hospital EMR produced a total of 5% of registry records with updated surgery information, 1% of records with updated radiation information, and 7% of records updated with chemotherapy information. Enhancement of registry treatment information was particularly affected by the availability of chemotherapy medications data.
Hospital EMR linkages to cancer disease registries is feasible but challenged by lack of standards for data collection, coding and transmission, comprehensive description of available data, and the exclusion of certain hospital datasets. The FCDS standard treatment data variables are highly robust and complete but can be enhanced by the addition of detailed chemotherapy regimens that are commonly used in patient centered outcomes research.
医院电子病历（EMR）系统在管理患者数据方面变得越来越集成，尤其是考虑到医疗保险和医疗补助服务中心最近发布的政策变化。除了数据管理之外，这些数据还为各种疾病（包括癌症）的以患者为中心的结果研究提供了证据。将 EMR 患者数据与现有的疾病登记处集成，加强了确保最佳健康结果的所有必要组成部分。
确定从医院 EMR 中提取、链接和处理数据的机制，并评估现有登记处治疗数据的完整性以及数据增强的潜力。
佛罗里达州卫生部门、FCDS 和一家大型佛罗里达医院系统建立了合作伙伴关系，以开发用于医院 EMR 提取和传输的方法。使用 ICD-9-CM 代码作为触发器，提取了 2007 年至 2010 年入院年份的记录，并将其与患有浸润性乳腺癌的癌症登记处进行了链接。
共链接了 11506 个独特的患者和 12804 个独特的乳腺癌肿瘤。对现有登记处治疗数据与医院 EMR 的评估产生了总共 5%的登记处记录具有更新的手术信息，1%的记录具有更新的放射信息，以及 7%的记录具有更新的化疗信息。登记处治疗信息的增强受到化疗药物数据可用性的影响。
医院 EMR 与癌症疾病登记处的链接是可行的，但受到数据收集、编码和传输标准、可用数据的全面描述以及某些医院数据集排除的限制。FCDS 标准治疗数据变量非常强大且完整，但可以通过添加常用于患者中心结局研究的详细化疗方案来增强。
