using precis hospital in sydney south west – val poxon
TRANSCRIPT
Using Précis Hospital Using Précis Hospital in Austral iain Austral ia
Val Poxon & Geoff DelaneyandSSWAHS Clinical Cancer Registry TeamCancer ServicesSydney South West Area Health Service
AcknowledgementSSWAHS Registry Support Team
SSWAHS CLINICAL CANCER REGISTRYAims & Objectives Collect NSW minimum dataset Provide timely, accurate and complete data
for all notifiable cancers Add value to statutory notifications Monitor patterns of care Measure quality and timeliness of care Use data locally to improve care & services
SSWAHS PROJECT DESIGN
Centralised approach Tumour based across SSWAHS Retrospective data collection New cases diagnosed from July 2005 Use existing Préécis Hospital Registry Database Manual data collection initially Migrate to electronic data transfer Monitor & Evaluate
Cancer Information Managers Portfol ios
Allocate CIM’s to a tumour site or sites based on estimated incidence rates of: approx 1000 cases ea per annum– Breast & Gynae– Colorectal & Upper GIT– Lung, CNS & Miscellaneous– Genito-urinary – Haematology, Head & Neck, Melanoma
Work Processes
Case finding by querying hospital systems
Transferring data to a form Enter data into Précis Run data quality edits Run reports using Crystal Reports
Case finding process
Anatomical Pathology reports Admitted Patients Data Collection Multidisciplinary Team meetings Oncology information systems Medical Oncology clinics Cancer Care Co-ordinators Doctors rooms Other databases & medical records
Can Précis Hospital Support this ???
Précis Review
What we l ike about Précis – Master Patient Index/Search facility– Class of case stratification– Tumour based– Look-ups relate to tumour– Automatic filling of some fields– Report construction processes
Précis Review
Functionality– Designed for US cancer reporting
systems– Has more functionality than we use– Does this mean we should be doing
things differently?– Many US standards do not apply to us– What are the Australian Standards?
Précis review cont’d
Operabil i ty– Screen layout doesn’t support all Australian MDS– Can create user-defined fields– Manual data entry is clunky because flow isn’t
smooth– Have to remember where data are stored when
creating reports– There are no guidelines about what some of the
fields are used for
Précis review cont’d
Bugs– Saving Drugs, Regimens and Protocols– TNM stage for C80 tumours– Forced over-writes do not appear in reports– Report queries fail to execute– Inconsistent reports– UDF captions fail to report– Date format for changing passwords
Précis review cont’d
Issues– No initial on-site training & lack of support– No access to US IMPAC training programs– No ICD-10 AM surgery codes– Insufficient date fields– Australia & UDF tabs are messy– PC sensitivity– Have to send nago-grams to get P1 installations– Not really set up to report to tumour groups
Précis review cont’d
Dislikes– Reporting capabilities– Lack of customised reports– Very little statistical functionality– Have to export data to excel/SPSS – Cannot change or add to fixed utilities– Crashes unexpectedly and locks users out– Have to wait for next version release for bug
fixes
Improvements/Opportunities Improvements/Opportunities
Notify IMPAC of bugs & issues Improve IMPAC response times Timely work-arounds until bugs can be fixed Discuss opportunities to address issues Develop a change control plan Better solutions from 24/7 help/support plus Can capitalise on and implement some of
Précis functionality into ClinCR project
Change Control Plan
Develop electronic data transfer to overcome clunkiness/improve efficiency
Work with IMPAC re SSWAHS data extract Work with IMPAC to customise database Work with IMPAC to re-engineer database
to import data extract Work with IMPAC to test imports Await release of new version with improved
functionality & bug fixes
Verdict on Précis
SSWAHS is the leading pilot site
Précis allowed us to get a head start
Great team effort to make Précis work
Opportunity for IMPAC to improve Précis functionality