NPCR-AERRO Project Description

NPCR-AERRO is a collaborative effort among public and private sector organizations committed to automating cancer registry operations and implementing electronic reporting from critical data sources to cancer registries for the purposes of increasing timeliness, quality, and completeness of data used to quantify the national cancer burden accurately.

NPCR-AERRO identifies cancer registry stakeholders from across the United States and invites them to participate in developing a cancer surveillance model; consensus and buy-in from this community are critical to develop and implement a model that can positively impact the way cancer registries operate. Stakeholders include representatives from the National Cancer Institute's Surveillance, Epidemiology, and End Results Program (SEER), the American College of Surgeons' Commission on Cancer (CoC), the North American Association of Central Cancer Registries (NAACCR), the College of American Pathologists (CAP), state cancer registries, state comprehensive cancer control programs, hospital cancer registries, national pathology laboratories, and software vendors. See the full list of participants below.

Scope

NPCR-AERRO focuses on all current and potential data sources for the hospital and central cancer registry levels. NPCR-AERRO focused on hospitals as a first priority because a majority of cancer data is received from this source. Electronic reporting of hospital data can improve the timeliness, completeness, and quality of cancer surveillance data reported at the state and national levels. Other sources, such as pathology and physicians' offices, can be addressed as well.

The NPCR-AERRO scope diagram is a simple flow diagram that identifies the multiple data sources in a ranked order, based on the quantity of useful data that are available and reported to the central cancer registry. This diagram provides a simplified high-level view of the project scope for the hospital and central cancer registry levels.

Rationale

The project addresses the ongoing presidential health initiative to implement an Electronic Health Record (EHR). NPCR-AERRO provides a means for the cancer surveillance community to contribute to developing and implementing tools that use the EHR. Several activities play a role in moving the President's initiative forward, including—

• Creating the Office of National Coordinator for Health Information Technology.
• Developing a functional model for an EHR system by Health Level 7 (HL7).
• Improving public health communications by using and promoting health data and technology standards by CDC's Public Health Information Network (PHIN).
• Adopting government-wide implementation of interoperability standards such as HL7, SNOMED, and LOINC by the eGov Consolidated Health Informatics project.

Standards

NPCR-AERRO uses widely accepted data and technical standards and protocols. The models developed in this project use industry standard messages and vocabularies so they can be implemented across the cancer surveillance community. Representative standards are listed below.

• American Medical Association (AMA) – Current Procedural Terminology (CPT)
• Health Level 7 (HL7)
• International Classification of Disease for Oncology (ICD-O)
• International Classification of Diseases, Ninth Revision (ICD-9)
• International Classification of Diseases, Tenth Revision (ICD-10)
• Logical Observation Identifiers Names and Codes (LOINC)
• National Health Information Network/National Health Information Infrastructure (NHIN/NHII)
• Public Health Information Network (PHIN)
• The North American Association of Central Cancer Registries (NAACCR)
• SNOMED Clinical Terms (SNOMED CT)
• Unified Modeling Language (UML)

Participants

CDC's National Program of Cancer Registries (NPCR) led NPCR-AERRO during Phase I, with the Virginia Commonwealth University's Health System (VCUHS), the Virginia Department of Health Central Cancer Registry (VCR), and the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) Program.

In Phase II, additional partners include—

• American College of Surgeons–Commission on Cancer
• College of American Pathologists
• Healthcare Information and Management Systems Society (HIMSS)
• National Cancer Registrars Association
• The North American Association of Central Cancer Registries

A number of organizations are participating in project activities, including—