1. NAACCR Data Standards Activities to Achieve Interoperability Ken Gerlach, Chair NAACCR Interoperability Ad Hoc Committee June 12, 2008 2008 NAACCR Annual Conference Denver, Colorado

2. NAACCR’s Number One Priority Achieve syntactic and semantic interoperability of cancer registration standards with national standards by 2010 or at the earliest possible time. Achieve syntactic and semantic interoperability of cancer registration standards with national standards by 2010 or at the earliest possible time.

3. Interoperability Ad Hoc Committee Structure Interoperability Ad Hoc Committee (Chair, Ken Gerlach) Semantic Interoperability Work Group (Chair, Gary Levin) Syntactic Interoperability Work Group (Chair, Beth Anne Schmidt) Pathology Data Work Group (Chair, Eric Durbin) Clinical Data Work Group (Co-chairs, Ken Gerlach and Jim Martin)

4. Context & Background Standards Volumes I and II Standards Volumes I and II  Starting in ~1994  (UDSC Convened 1987)  Data Dictionary: definitions & codes  Data exchange record layout – column format Electronic Reporting - Cancer Abstracts Electronic Reporting - Cancer Abstracts  National Standards for transmission

5. Definitions

6. Interoperability (IO) The ability of different information technology systems, software applications and networks to communicate, to exchange data accurately, efficiently and consistently, and to use the information that has been exchanged The ability of different information technology systems, software applications and networks to communicate, to exchange data accurately, efficiently and consistently, and to use the information that has been exchanged Source: The National Alliance for Health Information Technology Source: The National Alliance for Health Information Technology Ability of diverse systems and organizations to work together (inter-operate)

7. Semantic – Syntactic Semantic IO: the ability to exchange and use data; allows the exchange of both structure and meaning (of terms or vocabularies) among systems Semantic IO: the ability to exchange and use data; allows the exchange of both structure and meaning (of terms or vocabularies) among systems Syntactic IO: the ability to exchange data; refers to the ability for different systems to interpret interfaces, interchange formats, messaging standards, etc Syntactic IO: the ability to exchange data; refers to the ability for different systems to interpret interfaces, interchange formats, messaging standards, etc Semantic – meaning of communication Syntactic – rules of a language

8. Why? Increased emphasis on electronic health records (EHR) Increased emphasis on electronic health records (EHR)  State of the Union - 2004 focus  Health IT National Coordinator  Secretary Leavitt’s Leadership Standards for electronic transmissions are being set Standards for electronic transmissions are being set We want to be at the table to ensure cancer registry needs are met We want to be at the table to ensure cancer registry needs are met

9. IO Ad Hoc Committee Work Groups

10. Semantic IO WG Goal: Achieve semantic IO of cancer registry data items with national standards Goal: Achieve semantic IO of cancer registry data items with national standards Activities Activities Dates Dates National Provider Identifiers (NPI) National Provider Identifiers (NPI) Race Race caDSR caDSR

11. Dates – Data Items Current Current  Format - MMDDYYYY  Extra information: e.g. ‘88888888’ Proposed Proposed  Format –  YYYYMMDD  YYYYMM  YYYY  Flag fields

12. Syntactic IO WG Goal: Achieve syntactic IO of cancer registry data items with national standards Goal: Achieve syntactic IO of cancer registry data items with national standards Activities Activities Education Education  Tool Kit  Webinar caDSR caDSR

14. Pathology Data Work Group Goal: Develop messaging standards to facilitate the transmission of electronic pathology reports from anatomical pathology laboratories to cancer registries Goal: Develop messaging standards to facilitate the transmission of electronic pathology reports from anatomical pathology laboratories to cancer registries Activities Activities Electronic Pathology Data Items - for Volume II Electronic Pathology Data Items - for Volume II Volume V, Version 2.1 Volume V, Version 2.1  Updates & CAP Cancer Checklists Messaging Workbench (MWB) Messaging Workbench (MWB)  Posted Profile & Link Started Upgrade to HL7 Version 2.5.1 Started Upgrade to HL7 Version 2.5.1  Secretary Leavitt’s Recommendation

15. Clinical Data Work Group Goal: Explore alternate mechanisms or messages to transmit and receive (within and outside the cancer registry community) the cancer abstract (Volume II) to ensure consistency with national standards-related organizations Goal: Explore alternate mechanisms or messages to transmit and receive (within and outside the cancer registry community) the cancer abstract (Volume II) to ensure consistency with national standards-related organizations Activities Activities Pros – Cons of Change Pros – Cons of Change HL7 Clinical Document Architecture (CDA) HL7 Clinical Document Architecture (CDA) The Pilot: hospital to central The Pilot: hospital to central  Protocol  Transformations  Implementation Diagram  Time Line  Implementation Guide

16. Volume II Format Examples

17. Copyright Alschuler Associates, LLC 2006 17 Sample CDA

18. National Health Information Technology (IT) Initiatives

19. Tsunami of Acronyms

20. National Health IT Initiatives HITSP ( Healthcare Information Technology Standards Panel) HITSP ( Healthcare Information Technology Standards Panel) IHE (Integrating the Healthcare Enterprise) IHE (Integrating the Healthcare Enterprise) PHDSC (Public Health Data Standards Consortium) PHDSC (Public Health Data Standards Consortium) HL7 (Health Level Seven) HL7 (Health Level Seven) PERC (Pathology Electronic Reporting Committee) PERC (Pathology Electronic Reporting Committee)

26. Lessons Learned & Challenges Semantic & Syntactic concepts – hard to separate Semantic & Syntactic concepts – hard to separate Avalanche of information; multiple organizations Avalanche of information; multiple organizations Where to put our energy / efforts Where to put our energy / efforts Takes time Takes time Need expertise e.g. HL7 Need expertise e.g. HL7 We’re on a learning curve We’re on a learning curve There is not an existing trail to follow…we are trail blazing There is not an existing trail to follow…we are trail blazing

27. Thank you Acknowledgements Acknowledgements  Committee and Work Group members  Lori Havener