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Version 2 Development and Implementation

This session reviews the development and implementation of CSv2, highlighting successful aspects such as communication, training, organization, and people involvement, as well as areas for improvement, including communication, project management structure, and the overall process. Recommendations for future projects and ways to improve are discussed.

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Version 2 Development and Implementation

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  1. Version 2 Development and Implementation CSv2 Process Review Session March 23-24, 2010 Chicago, IL

  2. CS Process Review Session What Worked Well

  3. What Worked Well • Communication • Broad input from various stakeholders • Communication among and between CSv2 work groups and management team • Opportunity to share information, open communication • Use of technology to enhance communication • Relations with vendors

  4. What Worked Well • Training • Using web-based training • Identification of trainers for CSv2 • Dedicated web site for support • High quality educational materials

  5. What Worked Well • Organization of the Project • Structure worked well • Project Leader • Committees with specific tasks • Reporting back to project management team • Team structure-others’ expertise contributed new ideas, concepts, perspectives • Informatics structure-programming and testing

  6. What Worked Well • People • Many dedicated people with subject matter expertise • AJCC staff support • Willingness of most team members to work together • Talented and experienced technical leadership • Major players were involved

  7. CS Process Review Session What Didn’t Work Well

  8. What Didn’t Work Well • Communication • Not enough communication with cancer registry and surveillance community, vendors about progress • Not an open dialogue, power imbalance • Scope of Project • Project was bigger than most imagined—huge workloads

  9. What Didn’t Work Well • People • Too much reliance on volunteer staff • Project Management/Leadership Structure • Reporting structure-Decision-making process within teams/ authority/consensus/ problem-solving

  10. What Didn’t Work Well • Project Management/Leadership Structure (continued) • No change request process in place—formal log, tracking system, parking for issues in the future • Project management-resolving issues, not an open dialogue • Ineffective team management/leadership • Lack of defined authority structure

  11. What Didn’t Work Well • The Process • Repeatedly missed deadlines • Unrealistic schedule—lack of adequate time for all the steps in the process • Prep of AJCC chapters missed expected deadlines • From the beginning, lack of input from registrars

  12. What Didn’t Work Well • The Process (continued) • Needed early triggers to help make decisions about the process • Who can make decision to delay implementation deadlines • Recommendations for individual teams-set up a process for change requests • Style manual for mapping team

  13. What Didn’t Work Well • Training • Training and materials were developed too early

  14. CS Process Review Session What To Do Differently

  15. What To Do Differently • Project Management • Create formal project management structure and plan • Hire staff • Identify resources • Timeline • Refine timeline and stick to it, with milestones to trigger decisions • More lead time-begin process earlier

  16. What To Do Differently • In the Beginning • Involve registrars • Responsiveness from AJCC authors, more control over the chapters to ensure consistency • Analyze what can be collected and how it can be collected prior to starting the process • Determine balance between being up to date clinically and burdening the registries

  17. What To Do Differently • In the Beginning (continued) • Assess who is using registry data and for what purpose. • Evaluate the cost benefit of additional data items.

  18. CS Process Review Session Concurrent Development of AJCC 7th Edition and CSv2

  19. Concurrent Development • Yes • Many questions could be answered before the chapter was complete • Back and forth clarification/synchronization lead to better products on both ends • AJCC 7 and CSv2 linked together by item number and site-specific factors • CSv2 software includes new staging algorithms based on the AJCC 7th edition

  20. Concurrent Development • Yes, if…. • Registrar on each AJCC task force would have lead to the AJCC manual and CS being more in line • Chapter authors were more available to answer mapping team members’ questions • More involvement of data users in assessing the feasibility and usefulness of future changes

  21. Concurrent Development • No • CSv2 mapping was impeded by constant changes • At no point was there a stable system to test adequately • Large time burden on the CS project at the very end • Caused extreme hardship and difficulties in system development and testing

  22. Total Resources for CS 2009 Direct Dollars and In-kind Contributions • Total Financial Contributions for 2009 • 2,097,107 est. • Total in-kind Contributions for 2009 • $50,000 est. • Total project hours • 24,000 est./600 work weeks/12 full-time staff working 52 weeks per year • Doesn’t include team member meeting participation

  23. Moving Forward • AJCC Perspectives/CSv2 Maintenance • 6 FTEs + contractor support • 2 mappers • 1 programmer/IT specialist • 1 educator/trainer • 1 study specialist/analyst • .5 project manager • .5 admin asst. • Contracted team leads/clinical advisor • Volunteer team members • $620,000 est. • $520,000 salary and benefits • $25,000 contractor fees • $75,000 general operating expenses (meetings, conf. calls, etc.)

  24. Moving Forward • AJCC Perspectives/Resources for CSv3 • 13 FTEs + contractor support • 4-5 mappers • 2-3 programmer/IT specialist • 1 educator/trainer • 1 documentation developer/specialist • 1 study specialist/analyst • 1 project manager • 1 admin asst. • Contracted team leads/clinical advisor • Volunteer team members • $1,269,000 est. • $1,144,000 salary and benefits • $50,000 contractor fees • $75,000 general operating expenses (meetings, conf. calls, etc.)

  25. Moving Forward • …..with current funds • CSv2 Maintenance • $602,00 estimated • $322,019 available • $297,981 deficit • CSv3 Development • $1,269,000 estimated • $322,019 available • $946,981 deficit

  26. Next Steps • Hire a program manager and additional core/dedicated staff • Flow chart/define all components of CSv2 development process • Collaborate more closely with AJCC on staging system revision process • Develop a comprehensive project plan for annual vs. major version releases • Define budgetary needs • Develop pools of expertise around mapping and IT tasks • Evaluate and redefine teams and members • Train AJCC task force members/clinicians about CS • Define feasibility criteria and evaluate scope of changes • Engage the registrar and vendor communities early in the development process • Build in vetting, feasibility, and pilot testing of new concepts/major changes • Evaluate new technology environments for CS architecture

  27. Next Steps in 2010 • Data Validation Project • Review of site-specific schemas and tables for consistency, completeness and accuracy • Will result in some code changes and new codes • Conversion designed to handle majority of changes • Next major version release – Fall 2010 • Will incorporate all changes from data validation • Implementation Guide Revision • Posted on CS Web site this week • Clarifications to data items and processing of 2010 cases collected under CSv1 • Education and Training continues • Part 1, Section 1 Coding Instructions • Part 1, Section 2 Site-Specific Factors • Additional topics being developed • Field Test being planned for 2011

  28. CSv2 Tools • SEER Abstract Addendum Generator • For 2010 cases abstracted under CSv2 • Tool lists CS fields and space to abstract CSv2 pending software updates • CSv2 case exercises and answer sheets • Available for self-study on CS Website • Breast, prostate, colorectal • Printed Manual • NCRA planning mid-summer release of coding instructions and schemas • Price is $145 for NCRA members • Visit NCRA Web site • Site-specific schema in pdf • Available from CS Web site • Grouped by anatomic site, i.e., lower GI includes appendix, carcinoid appendix, GIST, etc. • Download schemas as needed, versus ALL

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