using precis hospital in sydney south west – val poxon

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