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Registry Plus™ eMaRC Plus Features and Future Plans

Version 5.0 — New Features

Version 5.0 was released on September 30, 2013. It includes a beta release of the new Physician Reporting module to receive and process documents from physician electronic health record (EHR) systems in a Health Level Seven (HL7) Clinical Document Architecture (CDA) format in accordance with the Meaningful Use Stage 2 Implementation Guide for cancer reporting from physician offices. A production release of the Physician Reporting module is scheduled for distribution in early 2014.

To obtain a copy of eMaRC Plus version 5.0, send a request.

eMaRC Plus includes two modules: ePath Reporting and Physician Reporting. Some features are highlighted below.

ePath Reporting Module

The ePath Reporting module now offers the ability to receive and process synoptic reports in an HL7 version 2.5.1 format in accordance with the North American Association of Central Cancer Registries (NAACCR) Volume V Pathology Laboratory Electronic Reporting standard. Enhancements include—

  • An improved user interface to minimize the number of steps and clicks required to complete a task.
  • Improved search capabilities.
  • An improved printing function.
  • The ability to create a blank abstract to include a path report that has been scanned into Adobe Acrobat® PDF format.
  • A new interface to maintain the reporting facility Clinical Laboratory Improvement Amendments (CLIA) number and a report template to show the number of reports by CLIA number.
  • The ability to autocode laterality for certain sites in narrative reports.
  • An integrated electronic reporting tool to calculate Collaborative Stage (CS) version 2.
  • Added functionality to receive and process synoptic reports and updated C-keys.
  • Updated to NAACCR version 13.

Physician Reporting Module

The Physician Reporting module allows state cancer registries to receive and process physician reports from EHRs in an HL7 CDA format in accordance with the implementation guide adopted for use in Meaningful Use Stage 2. In the beta release, users can—

  • Choose to work on Physician Reporting or ePath Reporting.
  • Configure the Physician Reporting module.
  • Import, browse, and open CDA documents.
  • Parse (programming to read the individual data elements) CDA documents using XPath.
  • Store extracted CDA data elements in relational tables.
  • Address repeating elements, entries, and null values.
  • Map CDA data elements to NAACCR layout.
  • Perform vocabulary/code translation.
  • Display CDA data elements on the left side of the screen, and mapped and translated NAACCR data elements on the right side of the screen.
  • View CDA documents in XML and report (using a stylesheet) formats.
  • Use a default abstract display type to select the fields to display on the right side of the screen.
  • Export CDA documents to NAACCR version 13 record layout.
  • Use export options similar to the ePath Reporting module (based on specified flags for CDA and export status).
  • Interact with the eMaRC Plus-generated database to open and find cases, and use a search function similar to the ePath Reporting module.
  • Use flags to facilitate CDA document processing.
  • View a tracking log for imported CDA documents.
  • Merge multiple records for the same patient and tumor that are received from the same facility.
  • Output in the following formats: NAACCR Record Type A abstract, Structured Query Language (SQL), and Microsoft Access database.
  • Create state-specific fields.
  • Interface with a transport mechanism.
  • Automatically process a message queue that contains CDA documents (multiple documents are imported as a batch).
  • Apply criteria for merging and/or exporting records.
  • Create separate abstracts from a single CDA document with more than one cancer diagnosis entry.
  • Pull/decode/decompress the CDA document from an HL7 message.

Future Plans

ePath Reporting Module

  1. Develop a service module (without a user interface) that imports HL7 messages from the Public Health Information Network Messaging System (PHINMS) queue and codes them without manual intervention.
  2. Integrate GenEdits.
  3. Improve autocoding of laterality.
  4. Add autocoding of grade for narrative reports.
  5. Update autocoding to take addendum reports into consideration.
  6. Highlight search terms in all sections of the report without affecting reportability or autocoding.
  7. Text mine for stage capture to autopopulate some or all of the CAP Cancer Checklist data elements, including Collaborative Stage.

Physician Reporting Module

  1. Enhance the CDA log file (XPath mapping) to address missing paths vs. nulls and provide a more user-friendly view.
  2. Add an abstract button to the abstracting side of the CDA workbench (same as for pathology records).
  3. Add an Oracle database output format.
  4. Add monitoring components—
    • Simple count report by reporter (practice or physician): number/month/week/year date reports; graph trend over time; by patient, report, or type of case (tumor site/type); non-reportables.
    • Feedback to reporters can be the same as the Monitoring Count Report.
  5. Enhance the CDA abstracting display type interfaces—
    • Add all abstracting lookups, including CS.
    • Support abstraction of all fields that can be added to the abstracting grid.
    • Add data quality editing capability (EDITS engine).
  6. Autocode histologic type and comorbidities. Identify or develop mapping tables to map ICD9-CM/ICD10-CM to ICD-O-3 and SNOMED.
  7. Validate structure.
  8. Validate content.
  9. Link the patient/tumor with the central registry database.
  10. Automatically export NAACCR abstracts.
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