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AUTOMATION IN PRACTISE: The SWCIS Experience. Presentated By: Tina Ball …………Head Of Registration Gill Christmas ……Head Of IT. 4th December 2002. Automation In Practise - SWCIS. Where Did We Start From?. Merging of 2 Registries – Wessex (part auto) South West (fully manual).

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Presentation Transcript
slide1

AUTOMATION IN PRACTISE:

The SWCIS Experience

Presentated By:

Tina Ball …………Head Of Registration

Gill Christmas ……Head Of IT

4th December 2002

slide2

Automation In Practise - SWCIS

Where Did We Start From?

Merging of 2 Registries – Wessex (part auto)

South West (fully manual)

Auto load of Clearnet for at least 8 years

No auto load of either pathology or deaths data

Deaths – 6 weeks to process

slide3

Automation In Practise - SWCIS

Where Are We Now?

Electronic Data Records Coverage

Clearnet - 700,000 - 100%

Pathology - 100,000+ (exp) - 83%

Cancer Deaths - 22,000 - 100%

X-regionals - 3,500 - 95%

slide4

Automation In Practise - SWCIS

Why Did We Go the ‘Auto’ Route?

1) Clearnet processing – 700,000+ records a year to handle

- capture of clinical data

2) Speed up Registration – more timely + improve availability

of information

3) Flexibility to handle constantly expanding data sources

slide5

Automation In Practise - SWCIS

The Auto Load Process

65 % Clearnet

No manual intervention

Overnight

Batch Processing –

80 % Cancer Deaths

Auto fill of demographics,

some tumour details and all

treatment (Clearnet)

Manual intervention

Recycled Records

Rapid processing of pathology

text

slide8

Strip off

Automation In Practise - SWCIS

keep

Processing Decisions – the ‘Markup’ process

Report : SWCRF SWCRF

Sort sequence : SWCRF SWCRF

Run Number : 52

Originally reported : 07/08/2000 08:05

Report date : 09/08/2000 11:33

[1m[1MOF-NINESEVEN [2m F23/07/1956Q123456

THE STARSHIP THE ENTERPRISEDr B CrusherQAH ITUQ

AA007007K/99

POST MORTEM HISTOLOGY

Sections from the greater omentum show diffuse infiltration by a

moderately differentiated adenocarcinoma as seen previously ……….

………………………..

Dr Test

SHO in Pathology

Test Hospital

ALPHA QUADRANT

DCT/GCS/JM 1.8.00

SNOMED CODES:

Seq 2 T57000 - M81403,

[1m

[2m

Dr I Test 847 25/05/2002 01/06/2002

[1m[1mBAGGINS BILBO [2m M 23/07/1956 P000000

Pathology

word document

slide9

Automation In Practise - SWCIS

Text added to assist

Registry officer

End Result

Q123456||19560723||F||THE STARSHIP,THE ENTERPRISE||OF-NINE|SEVEN|20020525|# Event Date: 20020525: # Hospital ENT02 : # Unit No: Q123456 # Clinician Name: B CRUSHER # Specimen Source: QAH # Pathologist Name: DR I TEST # Snomed Codes: T57000 - M81403, # Pathology Text: POST MORTEM HISTOLOGY ^ Sections from the greater omentum show diffuse infiltration by a ^ moderately differentiated adenocarcinoma as seen previously ………………^ Dr I Test ^ Test Hospital^

P000000|19560723|M|MIDDLE EARTH,THE LAND|BILBO|BAGGINS

Decided to use PERL:

Programming Extraction and Reporting Language

slide11

NHS Number

Unit Number

Birth Date

Surname

Forename

Address

Post Code

Morphology

ICD Site

Behaviour

Laterality

Automation In Practise - SWCIS

Patient/Tumour

Match

Data

clean &

validation

Data

extraction

Definate

Match & New

Clearnet

Cancerbase

Database

Perl

Markup

Markup

Database

Auto

InDefinate

match

Pool

Database

Path, pas

etc

Manual

Business Rules /

Data Validation

Manual

slide12

Automation In Practise - SWCIS

Automated Validation Rules

  • 35 reference tables within Cancerbase
  • On line cross validation checking, examples are
  • - AD later than DoD
  • - Site and Morph compatible
  • - Site and Behaviour compatible
  • - Stage Type and Stage
  • Based on ONS and UKACR guidelines
slide13

Automation In Practise - SWCIS

Burden On IT Dept

National GP, Consultant Hospital Codes OPCS 4 Codes ICD 10 Codes NHS no

CLEARNET:

- no names or addresses – nsts run

- different formats received within each field

- cleaning, validation and de-duplication

- scripts not static – data formats & content change

OTHER DATA SOURCES:

- separate script for each data source

- again scripts not static – data formats & content change

- multiple applications

slide14

Automation In Practise - SWCIS

Burden On IT Dept - contd

STAFF:

- increase in IT staffing levels – faults/enhancements

- availability & retention of skilled staff

- on-going training costs

slide15

Automation In Practise - SWCIS

3 Recommendations

BEFORE developing an automated Cancer Registration System ……………

1) Do not under-estimate the complexity of automating

the cancer registration process

2) Do not under-estimate the development costs and

on-going costs of support & maintenance

3) Test , test and test again

WE WISH YOU LOTS OF LUCK !