Florida Clinical Laboratory Cancer Identification Program CLIP Update

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Florida Clinical Laboratory Cancer Identification
Program(CLIP) Update

• FCDS 2002 Educational Teleconference Series
• http//fcds.med.miami.edu
• Mayra Alvarez, RHIT, CTR
• Mark Rudolph
• Gary Levin
• Steven Peace, CTR
• October 29, 2002

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Laboratory Data Contribution

• Case identification only
• Match laboratory data against masterfile
• Follow-back unmatched records to physician for
  abbreviated abstract

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CLIP Program Announcements

• February 8, 2002 - Program Announcement
• Letter of Introduction - John O Agwunobi, MD.
  MBA,
• Florida Secretary of the Department of Health
• Florida Cancer Reporting Legislation
• Florida Department of Health Administrative Rules

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CLIP Program Announcements

• June 7, 2002 Program Details from FCDS
• Program Outline
• Record Layout File Format Specifications
• DOH Program Announcement
• Laboratory Information Verification Form
• Teleconference Announcement

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Florida Statutes Legislation
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Us Downloads Law Rules Jobs FCDS IDEA
Direct any comments or questions to Jill
MacKinnon, Project Administrator.
What's New Welcome Statistics
Newsletters Questions Staff Links Contact
Us Downloads Law Rules Jobs FCDS IDEA
Direct any comments or questions to Jill
MacKinnon, Project Administrator.
6
Florida Statutes Legislation
7
Why Start This Program Now ?

• Federal directive to
• build capacity and infrastructure
• for cancer
• and other disease surveillance programs
• in order to meet
• current and future needs and goals
• of these programs

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Program Goals

• Ensure 100 Cancer Case ID
• Ensure 100 Cancer Case Reporting
• Enhance Existing Case Records
• Augment Coded Data

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HIPAA Cancer Reporting

• Information Reported under Public Health
  Authority that is authorized by state law to be
  collected for the purposes of preventing or
  controlling disease...and to conduct public
  health surveillance...as part of official mandate
  is specifically exempt from the HIPAA Rules a a
  covered entity which specifically makes
  allowances for reporting by physicians, clinical
  laboratories, in-patient and ambulatory patient
  care centers, state vital records and other
  covered entities.
• FAQs about HIPAA Cancer Reporting is available
  on the NAACCR website - http//www.naaccr.org

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What About Confidentiality ?

• Firewall between Web Server and Database
• Secure Access to Files
• Multiple Password Protection
• Internet Data Encryption
• Secure Internet Server
• Secure Transportation
• Secure Disposal
• IRB Approval for Data Release
• Annual Oath of Confidentiality

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Labs Who Must Report?

• All Hospital-Based Labs
• All Independent Labs
• All Dermatopathology Labs
• All Oral Pathology Labs
• All Out of State Labs licensed to read Florida
  specimens under contract or other condition

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My laboratory already works with a Cancer
Registry. Do I still need to report?

• Yes Cancer case ID under the CLIP Program is a
  completely separate program from the existing
  hospital and ambulatory patient care facilities
  cancer case abstracting and reporting program
• CLIP is an information systems case ID and
  reporting program, only
• CLIP will not replace cancer registry reporting

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Do I need to hire a cancer registrar to ID
report cases?

• NO !
• Clinical Labs do not need to hire
• professional cancer registrars
• or contract cancer case abstractors
• to meet ANY
• of the FCDS cancer case identification
• or clinical lab reporting program requirements

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Where do we to find the Path Lab information on
the web?
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Test Cases

• Test cases can be sent to FCDS to our programmer
  Mark on a floppy diskette by mail only
• OR
• Use the test check box option on the upload page
  to automatically test your data

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How Do We Report?

• Utilizing Web-based Software

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Click FCDS IDEA
19
Login
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Enter FCDS Supplied Username and Password
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Vendor Upload
22
Click Upload data file
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Type in file name you Wish to upload. File
created from your Vendor software
Click if you want to TEST the upload
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Single Record Data Entry
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Click Single Path Entry
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Type in CLIA Number
Information Will be Generated
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Complete Entry
Cut and paste from Your source document Into the
text areas
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Complete Entry and Click Submit
Cut and paste from Your source document Into the
text areas
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What Are Data Requirements?

• Refer to Pathology Case Record Layout
• Reporting Lab Information
• Required Data Items
• Optional Data Items
• NAACCR Standard Data Dictionary, Path Version

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Labs What Must Be Reported?

• All Histologically - Confirmed Cancers EXCLUDING
  BASAL AND SQUAMOUS CELL SKIN CANCERS
• What is a Reportable Cancer ?
• CDC and Florida DOH Definitions of Reportable
  Cancers
• ref ICD-O-3 behavior code of /2 (insitu) or /3
  (malignant)
• ref 2001 FCDS Data Acquisition Manual - Section
  I

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Labs What Must Be Reported?

• Case ID Procedures Must Include
• surgical pathology - diagnosis or treatment
• excisional or incisional biopsy
• needle biopsy cytology
• bone marrow biopsy
• electron micrograph
• other specialty
• consultation
• autopsy
• other
• DO NOT REPORT sputum, smears or other cytology

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Labs What Must Be Reported?

• Negative tissue samples received from wide
  excisions, colectomy specimen, mastectomy or
  other surgical treatment of malignancy
• Exclusions - DO NOT REPORT !!
• Basal Cell Carcinoma of Skin (non-genital skin
  sites)
• Squamous Cell Carcinoma of Skin (non-genital skin
  sites)
• In situ carcinoma of the cervix (CIS),
  intraepithelial neoplasia grade III of the cervix
  (CIN III) and intraepithelial neoplasia of the
  prostate (PIN III)

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3 Options for in-House Case Identification

• SNOMED Cancer Codes
• ICD-9 Cancer Codes
• Word and Word Combination File
• NAACCR Standard has a 800 word string
• Word/Word Combination List for Case ID
• Proven Track Record
• Excel File or PDF
• Versatile

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SNOMED Cancer Codes

• SNOMED Morphology "axis code structure codeset
• M-xxxx with as many as 18 characters in the
  codestring
• Select all cases with any Code M-8000 through
  M-9999
• Record Layout will allow up to 15 sets of SNOMED
  codes
• SNOMED Site/Topography axis code structure
• SNOMED uses T-xxx
• Not useful to FCDS
• May be useful for you
• Mapping tables may be needed to convert data
• Contact SNOMED for more information at
  http//www.snomed.org

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ICD-9 Cancer Codes

• ICD-9-CM Code(s) Diagnosis (in preferred ICD-O-3
  terminology)
• 042 AIDS (review cases for AIDS-related
  malignancies)
• 140.0 - 208.9 Malignant neoplasms (1o,
  primary, and 2o, secondary)
• 230.0 - 234.9 Carcinoma in situ all sites
  (exclude cervix 233.1)
• 235.0 - 238.9 Neoplasms of uncertain behavior
• 236.0 Endometrial stroma, low grade (M8931/3),
  (236.0)
• 236.0 Endolymphatic stromal myosis,
  (M8931/3), (236.0)
• 236.0 Endometrial stromatosis, (M8931/3),
  (236.0)
• 236.0 Stromal Endometriosis, (M8931/3),
  (236.0)
• 236.0 Stromal myosis, NOS (M8931/3), (236.0)
• 237.5 Ependymoma (epithelial) (malignant)
  (M9391/3) papillary, (237.5)
• 237.6 Papillary Meningioma (M9538/3), (237.6)
• 238.4 Polycythemia (primary) (rubra) (vera)
  (M9950/3), (238.4)
• 238.6 Solitary plasmacytoma (M9731/3)
• 238.6 Extramedullary plasmacytoma (M9734/3)
• 238.7 Chronic myeloproliferative disease
  (M9960/3)
• Continued

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ICD-9 Cancer Codes

• Select cases with ICD-9 Code appearing in the
  list
• Case Required ICD-9 cancer diagnosis code
• Case Optional ICD-9 code indicates
  non-reportable cancer or patient with history of
  cancer, inactive disease or patient seen for
  follow-up
• Data can include a combination of alpha and
  numeric characters
• Data can include a decimal point for higher level
  specificity
• Code can be up to 10 characters in length
• Record Layout will allow up to 6 sets of ICD-9
  Codes

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NAACCR 800 Word Search File

• Use this file to search the text areas of your
  word processing, spreadsheet or database report
  files where information from the final pathology
  report is stored
• Includes all cancer cancer-related terms
• The listing over-selects some types of cancer
  cases as a normal part of operation,
• Non-reportable cancers will be deleted from the
  database on visual review by FCDS
• http//www.fcds.med.miami.edu or
  http//www.naaccr.org/Standards/pathlabcom.html

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NAACCR 800 Word Search File

• ADENOCARCINOMA
  
• ADENOID SQUAMOUS CELL CARCINOMA
  
• ADENOSQUAMOUS CARCINOMA
  
• ADNEXAL CARCINOMA
  
• ADRENAL CORTICAL CARCINOMA
  
• ADULT T CELL LEUKEMIA
  
• ADULT T CELL LYMPHOMA
  
• AIN 23
  
• AIN 3
  
• AIN GRADE III
  
• AIN III
  
• ALEUKEMIC GRANULOCYTIC LEUKEMIA
  
• ALEUKEMIC LEUKEMIA
• http//fcds.med.miami.edu/downloads/PathLab/
• Continued
  

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How Must Cases Be Submitted?

• ASCII File (text file)
• Tab Delimited
• No Headers
• No embedded CR/LF, TABS, Quote () or other
  control characters
• Left Justified Blank Filled
• Dates in CCYYMMDD format
• One CR/LF sequence at end of each record

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CLIP - Deadlines

• December 31, 2002 Deadline
• Case Reports from January 2002 through June 2002
  are DUE January 2003 - FCDS will contact all
  non-compliant labs
• June 30, 2003 Deadline
• Case Reports from July 2002 through December 2002
  are DUE July 2003 - FCDS will contact all
  non-compliant labs
• August 2003 - DOH will contact remaining
  non-compliant labs
• October 2003 - AHCA division of licensing
  notified for non-compliance

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Stay Informed

• FCDS Website - http//www.fcds.med.miami.edu
• Path Lab Program Announcement Info Packet
• Laboratory Information Verification Form
• Teleconference slides notes on FCDS website
• FCDS Monthly Memo
• FCDS Quarterly Newsletter
• FCDS Teleconferences
• FCDS Annual Conference
• Call us _at_ 1-800-906-3034

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Useful Cancer-Related Websites

• FCDS - http//www.fcds.med.miami.edu
• CDC/NPCR - http//www.cdc.gov/cancer/npcr
• NAACCR - http//www.naaccr.org
• CAP - http//www.cap.org
• SNOMED - http//www.snomed.org
• NCI Main Cancer Info - http//cancer.gov
• NCI/SEER - http//seer.cancer.gov
• ACoS/COC - http//www.facs.org/dept/cancer
• Florida DOH - http//www.doh.state.fl.us
• Florida C-CRAB - http//www.moffitt.usf.edu/ccrab
• Florida Legislature - http//www.leg.state.fl.us/S
  tatutes

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Acronyms

• FCDS Florida Cancer Data System
• CDC/NPCR Centers for Disease Control
  Prevention/ National Program of Cancer
  Registries
• NAACCR North American Association of Central
  Cancer Registries
• CAP College of American Pathologists
• SNOMED Systemized Nomenclature of Medicine
• NCI National Cancer Institute
• NCI/SEER National Cancer Institute/
  Surveillance, Epidemiology
  End-Results Program
• ACoS/COC American College of Surgeons/
  Commission on Cancer
• Florida DOH Florida Department of Health
• C-CRAB Florida Cancer Control Research
  Advisory Council
• Legislature Our Elected Officials in
  Tallahassee

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For Additional Information Contact Us

• Florida Cancer Data System
• University of Miami School of Medicine
• P.O. Box 016960 (D 4-11)
• Miami, Fl 33101
• 1-800-906-3034
• Phone [phone] Fax [phone]
• http//fcds.med.miami.edu

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THANK YOU !
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QUESTIONS ???

• And now, Questions. We will be jotting down
  your questions, and will include them in the next
  FCDS Monthly Memo. All FCDS Teleconferences are
  valid for Continuing Education credit. A one
  hour teleconference equals one hour on your CE
  form. Also, we do have a list of all of the call
  in sites should you ever need a copy for
  Continuing Education Auditing purposes. Just
  contact us and we will send you a copy.
• TO ASK A QUESTION - Press 1 then 0 on your phone
  and you will be placed as the next caller. You
  will hear You will be notified when the
  speaker/host is ready for your question.
• Once the speaker is available to answer your
  question, you will hear Please ask your question
  after the tone.
• To Withdraw Your Question - After you enter 1 and
  0, if you decide to withdraw your question, then
  just press 1 and 0 again.