Skip directly to search Skip directly to A to Z list Skip directly to navigation Skip directly to page options Skip directly to site content

NPCR-AERRO ePath Reporting Workgroup

Purpose and Goals

The information collected and included in the pathology laboratory reports represents a critical data source for state cancer registries. Currently, some registries still lack the resources either to obtain and process paper pathology reports or to implement their own electronic pathology (ePath) reporting systems. Many laboratories lack resources and infrastructure to implement ePath reporting. The need to retrieve data from the pathology report in a more efficient and timely fashion is driving the development of an automated electronic process for accessing and using pathology reports to identify cancer cases.

NPCR-AERRO’s goal is to implement electronic pathology reporting from laboratories at the national, state, and local levels to the appropriate state cancer registries. Activities are focused on working with the national laboratories and laboratory information system vendors to implement electronic reporting of pathology reports according to the NAACCR Pathology Laboratory Electronic Reporting Volume V standard and the business rules defined in the NAACCR Electronic Pathology (E-Path) Reporting Guidelines.

eMaRC Plus

Electronic Mapping, Reporting, and Coding (eMaRC) Plus, the newest Registry Plus™ application, is a software tool developed to view and work with HL7 messages and documents. The application was developed collaboratively by participants in NPCR-AERRO’s ePath Pilot Project and programmed by CDC’s Registry Plus Development Team.

Activities and Timeline


Activity Status Release Date
Develop Approve a Pathology Laboratory for Electronic Reporting use case [PDF-815KB] Complete September 2011

Analysis and Design

Activity Status Release Date
Work with LabCorp to develop the Health Level Seven (HL7) v.2.3.1 ORU message of pathology reports using the NAACCR Volume V standard. Complete September 2006, February 2009
Use the HL7 Messaging Work Bench tool to validate the HL7 v.2.3.1 message received from LabCorp. Complete June 2007
Work with LabCorp and state cancer registries to identify and/or develop a methodology to filter out the appropriate cancer pathology reports for transmission. Complete May 2006, August 2008
Develop a tool to retrieve pathology reports in the HL7 ORU message and HL7 pipe-delimited format from the PHINMS queue at the state health department and process the pathology reports for inclusion in the state cancer registry software. Complete September 2006
Enhance design of eMaRC Plus tool. See specific planned enhancements. Ongoing Not applicable
Analyze and evaluate text mining and natural language processing technologies. See Evaluation of Open Source Text Mining Tools for Cancer Surveillance: Phase I: Understanding Text Mining and Identifying Tools [PDF-300KB]. Complete 2007
Map CAP Electronic Cancer Checklist (eCC) data elements to required NAACCR standards. See NAACCR Volume V: Pathology Laboratory Electronic Reporting Version 4.0 (April 2011) Complete August 2010


Activity Status Release Date
Write a final report [PDF-2MB] for Phase 1 of implementing electronic pathology laboratory reporting from a national laboratory to state central cancer registries Complete November 2007
In eMaRC Plus, implement a negation finder called Negex, a process used by virtually all natural language processing tools to identify negated terms Completed April 2010
Coordinate ePath Reporting Workgroup meetings with states, labs, NAACCR, and others to reach consensus on various components of ePath reporting Ongoing None
Implement PHINMS in all NPCR-funded state cancer registries. See map for progress. In progress None
Implement ePath reporting in additional national and large regional laboratories with all state cancer registries. Ongoing None