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Frequently Asked Questions About Meaningful Use: General (Questions 1–13)

  1. What are the steps to implement cancer reporting in Stage 2?
  2. Is there a duplication of effort in reporting cancers by having both hospital registries and physician offices submit information? Will this cause additional work for central registries?
  3. Physicians may be unhappy if they are asked to report more information than absolutely necessary. How much additional work will this cause physicians?
  4. Do these requirements apply to ambulatory centers and radiations facilities?
  5. What does ELR stand for?
  6. The Guidance for Implementing Public Health Agency/State Cancer Registry MU document states the registry must do all of these steps, but this is just a guidance document. Is that correct?
  7. How do we prioritize which providers to work with first?
  8. Can I learn from participating states the amount of staff and time required to begin this process and validate providers’ data?
  9. Has either of the pilot states developed sample position descriptions or duty statements?
  10. If the state receives physician forms electronically, does that meet CDC’s reporting requirements?
  11. If an oncologist is not on board for MU Stage 1, can they start that process in 2013?
  12. Can a state cancer registry use a vendor that has clients who are doing MU to get reports from providers who are not doing MU at all?
  13. May providers be exempt from this process if their cases are reported by a hospital or if their volume is below a certain threshold?
  1. What are the steps to implement cancer reporting in Stage 2?

After providers register and discuss their intent to report with the public health agency (PHA), they send test data to the state cancer registry. When the registry determines that the test data are valid, they work with providers to set a go-live date.

  1. Is there a duplication of effort in reporting cancers by having both hospital registries and physician offices submit information? Will this cause additional work for central registries?

It is not a duplication of effort for the hospitals and physician offices. Physicians are required to report cancer cases to the registry. Cases that are diagnosed and treated outside of hospitals have been historically underreported.

Some cancer cases will be reported twice, although the information provided by each source may not be exactly the same. Beyond adding missing treatment information, the state cancer registry will decide how to process physician reports for which a hospital cancer registry abstract already exists.

  1. Physicians may be unhappy if they are asked to report more information than absolutely necessary. How much additional work will this cause physicians?

The objective of this effort is for the electronic health record (EHR) to do as much of the work as possible so that physicians and office staff do not have to fill out additional forms or enter information into a separate application. There should be little need for follow-up because the information in the medical record will have been sent at the time it was gathered.

Physicians may need to enter some new information when they document the encounter to adhere to North American Association of Central Cancer Registries (NAACCR) standards and the American Society of Clinical Oncology’s requirements for a cancer patient.

  1. Do these requirements apply to ambulatory centers and radiations facilities?

This process applies to eligible professionals (EPs) who diagnose or treat cancer patients. The Centers for Medicare & Medicaid Services (CMS) provides a detailed overview.

  1. What does ELR stand for?

Electronic laboratory reporting.

  1. The Guidance for Implementing Public Health Agency/State Cancer Registry MU document states the registry must do all of these steps, but this is just a guidance document. Is that correct?

Yes. But you must do most of the steps, such as those listed in phases 2 and 3 [PDF-431KB].

  1. How do we prioritize which providers to work with first?

CDC provided some general guidance in an e-mail message sent to program directors on January 31, 2013, titled CDC-NPCR Program Standards, Guidance Documents, and Progress Template. The attached Physician Reporting Guidance document recommended focusing on dermatology, urology, gastroenterology, hematology, medical oncology, radiation oncology, and independent surgery providers first because of known underreporting of certain types of cancers. You may also want to consider the volume of cases that a specific facility would report.

  1. Can I learn from participating states the amount of staff and time required to begin this process and validate providers’ data?

Two states are currently pilot testing EHR physician reporting to their registries. In Kentucky, the registry has identified a need for a staff person to coordinate with providers and vendors. Staff members need to be involved in scrutinizing incoming records. You can also look at the processes used with your other public health programs during stage 1.

CDC will offer technical support, including manual analysis of sample files and development of a validation tool.

  1. Has either of the pilot states developed sample position descriptions or duty statements?

Kentucky will contribute to those descriptions.

Maine has one person who spends 2–3 hours per week scheduling and attending meetings, as well as participating in a cross-agency task force. Other activities include investigating options for funding.

  1. If the state receives physician forms electronically, does that meet CDC’s reporting requirements?

The Implementation Guide for Ambulatory Healthcare Provider Reporting to Central Cancer Registries [PDF-1.9MB] (commonly called the Cancer Implementation Guide) was developed to meet state reporting requirements. We expect all EHRs that comply with the guide to report data that will enable states to meet CDC’s reporting requirements.

  1. If an oncologist is not on board for MU Stage 1, can they start that process in 2013?

EPs must start the process at the beginning of a calendar year. They would start MU Stage 1 on January 1, 2014, and continue for 2 years before moving to MU Stage 2.

  1. Can a state cancer registry use a vendor that has clients who are doing MU to get reports from providers who are not doing MU at all?

Missouri found that this approach is possible, but there could be an additional cost to providers.

  1. May providers be exempt from this process if their cases are reported by a hospital or if their volume is below a certain threshold?

A provider may take an exemption in two ways. The provider, not the public health agency (PHA), determines if the provider qualifies for an exemption. The provider may be exempt from reporting requirements if the state doesn’t have the capacity to receive the data or if the provider does not see cancer patients.

 
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