A reminder that the membership renewal period ends on the 31st. Applications will be closed as of April 1. Also, we have a date and venue for the Fall meeting. We have booked the Sonntag Pavilion again for October 9th and 10th. Please let us know what topics you would like to have discussed at the meeting.
IPod Winner Announcement
The Board is very happy to announce the winner of the 2014 membership drive drawing is Rose Ross, CTR of Banner Healthcare. Rose was notified today and we are making arrangements to deliver her new IPod. We will be having a similar drawing during early registration this year for the annual meeting. If you have suggestions for desirable prizes please let us know. Congratulations Rose!
Candi Rucker – Membership Chair
Thank You
As I exit the presidential role for 2013 I just want to extend my thanks to the members of the CRAAZ board and the members of the organization who made this a productive and satisfying year. The women of the 2013 board (Kyle Coppola, Lori Grobe, Sandie Steen, Melanie Zaleski, Mary Stumbough, Valeri Martin, Lorna Niven and Nadine Wright) are professional, thoughtful and dedicated leaders and mentors who brought their individual strengths to the organization and shared them freely. Board and non board members alike made this experience educational and above all fun! I realize this may not be the usual use of the word fun, but I assure you our board meetings rocked! Thank you again for a wonderful experience.
Candi Rucker
Wrapping Up 2013
Having a little lunch and just wanted to say thank you so much for attending the Fall Conference. We had 67 registered attendees and 6 vendors and I know the entire board appreciates your support of the organization. The 30th anniversary was special and I hope you enjoyed the commemorative padfolios as well as the topics. St. Joseph’s catering did a lovely job. I encourage you to get active within the organization and join our next president, Lori Grobe, to make next year even better!
Candi
Candi
SEER Educate Released
SEER has announced the release of SEER*Education, an online training platform for people in the cancer registry profession or who are interested in working in the registry. The product makes available 295 practice cases across the twelve largest primary site groups for coding using the Collaborative Stage version 02.04 and the 2013 SEER Program Coding and Staging Manual. Practice exercises are currently available on Medical Terminology, Statistics, Computer Principles, and Commission on Cancer Standards. New content will be made available quarterly. The application currently is only available with the web browser Mozilla Firefox. You can get started at https://educate.fhcrc.org SEER*Educate is funded by Surveillance, Epidemiology and End Results (SEER) of the National Cancer Institute (NCI) and the Fred Hutchinson Cancer Research Center.
The NCRA Formal Education Program Review Committee is looking at ways that students who are working on the 160-hour clinical practicum can gain some of the experience they need abstracting/coding via a virtual product. They are currently evaluating this product to see whether it fulfills the requirements.
Registration Opens for CRAAZ Annual Meeting 2013
Registration opens for the annual meeting today. As usual, you may register by downloading and completing the form and mailing it with your check to the post office box. This year we also offer the option to register and pay online. http://craaz.info/events/ We have an exciting slate of speakers this year and will be applying to NCRA for 9 CE credits over two days. Linda Reimers, RHIT, CTR from Registry Partners and Dr. Ted Williamson, MD, CTR the Data Quality Coordinator of the Salem Health Cancer Registry will be reprising their presentations from the 39th Annual NCRA Conference. Dr. Samuel Aguayo, Associate Chief of Research at the Phoenix VA Medical Center will be discussing new data on lung cancer screening, treatment and survival. Georgia Yee, BS, CTR Office Chief at the Arizona Department of Health Services will also be bringing us information on Meaningful Use of the Electronic Health Record. That’s just the first day! On the second day we are privileged to have Kevin Potter, MD from St Joseph’s who will discuss with us Minimally Invasive GI Surgery as well as Kyle Coppola, RHIT, CTR from the Mayo Clinic who will discuss Adapting Casefinding Strategies and I will be presenting some ideas on Quality Control in Non CoC Approved Hospitals.
The Early Bird discounted fee is available only until September 3oth, please register soon and help us celebrate our 30th anniversary as an organization.
New Version of CoC Standards Manual
The Commission on Cancer (CoC) New announced that they are wrapping up its project to review, revise and enhance the CoC standard for accreditation. These standards will go into effect January 1, 2020. You can find a copy of the draft minutes click here. The proposed date of finalization of the standards manual is Fall 2019.
The August 1, 2013 CoC Source announced that the new version of the CoC Program Standards will be delayed until late September. The CoC did detail some of the upcoming changes which include:
1. As of July 1, Standard 5.2 will be changed from abstracting timeliness to a new standard focused on Rapid Quality Reporting System (RQRS) participation. The RQRS standard will become effective on January 1, 2014, will be valid for commendation only, and will be part of the Outstanding Achievement Award criteria beginning in 2014.
Abstracting timeliness of 2011 cases will continue to be evaluated during the remaining 2013 surveys. Any deficiencies given for abstracting timeliness will be resolved by on-time submission of the 2012 cases to the National Cancer Data Base (NCDB) in January 2014.
2. Immediately eliminate surveyor review of cases selected for one of the Cancer Program Practice Profile Reports (CP3R) measures during the on-site visit. The review may be reinstated by the Accreditation Committee when needed to validate new performance measures. Programs will be notified in advance if the review is reinstated.
3. Retire the 2009 Standards from the survey process beginning January 1, 2014. This change will not affect surveys performed during 2013 which will continue to review 2010 and 2011 activity using the old standards and 2012 using the new standards. For 2014 surveys, the Outstanding Achievement Award criteria will be adjusted to apply to activities in 2012 and 2013 using only Cancer Program Standards 2012: Ensuring Patient-Centered Care.
Development of the RQRS standard is now complete, and the Accreditation Committee will consider this change at the August 20 conference call meeting. Version 1.2 will be completed following this meeting and published online in late September. A special issue of The CoC Source will announce the release of Version 1.2.
NCRA 39th Annual Educational Conference
NCRA was an incredible experience. The national and local coordinators did an excellent job with topics, speakers and site management. Presenters speaking to some very exciting topics on the linking of quality measures to Medicare reimbursement under the Affordable Healthcare Act (AHCA), the American Taxpayer Relief Act (ATRA), Health Information Technology and Economic and Clinical Health Act (HITECH) and the implementation of ICD 10M. As new provisions of these laws roll out over 2013 and 2014 you will be interested to know I think how this impacts cancer registries. Under these acts the model of fee for service is being replaced by fee for performance as Medicare reimbursement will be tied to meeting specified quality measures. Meaningful use of the electronic health record to improve quality of care was discussed at length. Reporting cancer cases to the state cancer registry is one of the menu options for compliance by eligible providers. Participating in the Rapid Quality Reporting System through the Commission on Cancer (CoC) accreditation process has been recognized by the Centers for Medicare/Medicaid Services (CMS) as meeting one of the quality measures for hospitals. RQRS is only available to CoC approved hospitals. The Hospital Inpatient Quality Reporting (HOQR) mandated by Medicare in 2003 and the Hospital Outpatient Quality Reporting (HOQR) mandated in 2006 reduces reimbursement to hospitals that do not report compliance with quality measures (57 measures). The Centers for Medicare/Medicaid Services (CMS) is currently testing oncology quality measures with 11 hospitals nationwide. As part of this project CMS has contracted with the CoC to provide performance measure data (CP3R) for these pilot hospitals. The CoC has submitted five new quality measures to the National Quality Forum for endorsement. The quality measures for Standards 4.4 and 4.5 will be expanded as well as existing measures enhanced. The next measure up for consideration is the number of mediastinal lymph nodes taken in a staging mediastinoscopy for lung cancer cases. A new version of the CoC program standards manual is due out in July 2013.
How will this come together and how will it affect your registry? Truthfully, I don’t think the process is completely defined. There are a variety of options for eligible providers and eligible hospitals to meet quality measures. These measures must necessarily have some flexibility to their structure since not all hospitals provide the same clinical services or have the same patient mix or clinical needs. For hospitals who have a significant cancer population though, it is not a stretch to say that administrators are biased to using existing data sources rather than inventing new ones. The use of clinical registries to document outcomes that affect reimbursement may put new focus on the cancer registry. In light of CMS already recognizing participation in RQRS as a qualifying performance measure, those hospitals already approved by the CoC may be better positioned to document compliance with quality of care and improve their reimbursement. In addition, the CMS is aware of the quality measures already in place in approved hospitals and publication of that data is part of the pilot project underway. The emphasis on measurable quality outcomes may spur a more extensive use of registry data and build relationships with other departments. The cancer registry as an isolated data enclave may be going the way of the dinosaur. How is your registry positioned for this transition? Do you know your data? Do you trust it? Quality and completeness have always been important, they are essential now. What can you do to be ready to promote the administrative and clinical applications of the registry data? What are your thoughts on the benefits and challenges to a more “meaningful use” of registry data?
Hospital Inpatient Quality Reporting Requirements: https://www.qualitynet.org/dcs/ContentServer?c=Page&pagename=QnetPublic%2FPage%2FQnetTier3&cid=1138900297065
Hospital Outpatient Quality Reporting Requirements: https://www.qualitynet.org/dcs/ContentServer?c=Page&pagename=QnetPublic%2FPage%2FQnetTier3&cid=1192804531207
NQF Endorsed Measures Related to Cancer Care: https://www.qualityforum.org/Publications/2012/06/Performance_Measurement_Coordination_Strategy_for_PPS-Exempt_Cancer_Hospitals.aspx
Hospital Compare Website: www.hospitalcompare.hhs.gov
http://www.healthit.gov/policy-researchers-implementers/meaningful-use
Thank You
Past President Nadine Wright very thoughtfully presented an engraved gavel and strike plate to the association in honor of our 30th year as an organization. Thank you Nadine.
Mentoring the New Registrar – Guest Blog by Melanie Zaleski
Have you ever heard anyone say they want to be a “Cancer Registrar” when they grow up? Well I have not. The usual response when someone asks what you do for a living is “I have never heard of that field before”. As most of us in the field did not want to “grow up” to be a Cancer Registrar and stumbled into the position one way or another, it is difficult to promote a field that is not widely known or on any lists of college programs for students to think about.
For those of us in the field of course, we talk about it and try to recruit anyone that seems remotely interested. However, the conversation usually ends there because moving to the next step is where we find the stumbling blocks. While there are educational avenues to obtain a degree in Cancer Registry they are mainly on line, self taught and with little to no mentoring. A student is required to have 160 hours of onsite training but as registrars know there are not 160 hours in anyone’s schedule to give up to mentor, train or even look at a student. Not only is there the time issue but there is the cooperation of hospital administration to agree to let the student in the door, having space for a student to work and then finding a schedule that works for the student and the mentor. Once all that is accomplished how do you squeeze everything a new registrar needs to know that is not in any book into 160 hours??
With changes in the standards every year and what seems like a million data fields that are collected, education is key to keeping a student from running toward the door and shaping them into a well rounded new registrar that can benefit a program from day one. The quote “it takes a village to raise a child” can also apply to the training of a new registrar as it takes a community to raise a well rounded Cancer Registrar.
With cancer programs expanding all over the city and no one to recruit, we in the registrar community need to mentor fledgling registrars, promote the field and find ways to work together to raise the next generation of registrars. If you don’t have 160 hours do you have 25-30? If we work together to create a rotation of training, we could create the village needed…….