automation in practise: the swcis experience presentated by: tina ball …………head of...
TRANSCRIPT
AUTOMATION IN PRACTISE:The SWCIS Experience
Presentated By:
Tina Ball …………Head Of Registration
Gill Christmas ……Head Of IT
4th December 2002
Automation In Practise - SWCIS
Where Did We Start From?
Merging of 2 Registries – Wessex (part auto) South West (fully manual)
Auto load of Clearnet for at least 8 years
No auto load of either pathology or deaths data
Deaths – 6 weeks to process
Automation In Practise - SWCIS
Clearnet - 700,000 - 100%
Pathology - 100,000+ (exp) - 83%
Cancer Deaths - 22,000 - 100%
Electronic Data Records Coverage
X-regionals - 3,500 - 95%
Where Are We Now?
Automation In Practise - SWCIS
Why Did We Go the ‘Auto’ Route?
1) Clearnet processing – 700,000+ records a year to handle - capture of clinical data
2) Speed up Registration – more timely + improve availability of information
3) Flexibility to handle constantly expanding data sources
Automation In Practise - SWCIS
The Auto Load Process
No manual interventionOvernightBatch Processing –
65 % Clearnet
80 % Cancer Deaths
Manual interventionRecycled Records
Auto fill of demographics,some tumour details and all treatment (Clearnet)
Rapid processing of pathologytext
Auto loaded
Auto loaded
Processing Decisions – the ‘Markup’ process Report : SWCRF SWCRF Sort sequence : SWCRF SWCRF Run Number : 52 Originally reported : 07/08/2000 08:05 Report date : 09/08/2000 11:33 [1m[1MOF-NINE SEVEN [2m F 23/07/1956 Q123456 THE STARSHIP THE ENTERPRISE Dr B Crusher QAH ITUQ AA007007K/99 POST MORTEM HISTOLOGY Sections from the greater omentum show diffuse infiltration by a moderately differentiated adenocarcinoma as seen previously ……….……………………….. Dr Test SHO in Pathology Test Hospital ALPHA QUADRANT DCT/GCS/JM 1.8.00 SNOMED CODES:Seq 2 T57000 - M81403, [1m [2mDr I Test 847 25/05/2002 01/06/2002 [1m[1mBAGGINS BILBO [2m M 23/07/1956 P000000
Pathologyword document
Automation In Practise - SWCISStrip off
keep
End Result Q123456||19560723||F||THE STARSHIP,THE ENTERPRISE||OF-NINE|SEVEN|20020525|# Event Date: 20020525: # Hospital ENT02 : # Unit No: Q123456 # Clinician Name: B CRUSHER # Specimen Source: QAH # Pathologist Name: DR I TEST # Snomed Codes: T57000 - M81403, # Pathology Text: POST MORTEM HISTOLOGY ^ Sections from the greater omentum show diffuse infiltration by a ^ moderately differentiated adenocarcinoma as seen previously ………………^ Dr I Test ^ Test Hospital^ P000000|19560723|M|MIDDLE EARTH,THE LAND|BILBO|BAGGINS
Decided to use PERL:Programming Extraction and Reporting Language
Automation In Practise - SWCIS Text added to assistRegistry officer
Dataextraction
Dataclean &validation Definate
Match & New
InDefinate match
Business Rules /Data Validation
Auto
Manual
PerlMarkup Markup
Database
PoolDatabase
CancerbaseDatabase
Manual
Path, pasetc
Clearnet
Automation In Practise - SWCIS
Patient/TumourMatch
NHS Number
Unit Number
Birth Date
Surname
Forename
Address
Post Code
Morphology
ICD Site
Behaviour
Laterality
Automation In Practise - SWCIS
Automated Validation Rules
35 reference tables within Cancerbase
On line cross validation checking, examples are
- AD later than DoD
- Site and Morph compatible
- Site and Behaviour compatible
- Stage Type and Stage
Based on ONS and UKACR guidelines
Automation In Practise - SWCIS
Burden On IT Dept
CLEARNET:- no names or addresses – nsts run
- different formats received within each field
- cleaning, validation and de-duplication
OTHER DATA SOURCES:- separate script for each data source
- again scripts not static – data formats & content change
- scripts not static – data formats & content change
- multiple applications
National GP, Consultant Hospital Codes OPCS 4 Codes ICD 10 Codes NHS no
Automation In Practise - SWCIS
Burden On IT Dept - contd
STAFF:- increase in IT staffing levels – faults/enhancements
- availability & retention of skilled staff
- on-going training costs
3 RecommendationsBEFORE developing an automated Cancer Registration System ……………
1) Do not under-estimate the complexity of automating the cancer registration process
WE WISH YOU LOTS OF LUCK !
Automation In Practise - SWCIS
2) Do not under-estimate the development costs and on-going costs of support & maintenance
3) Test , test and test again