National Program of Cancer Registries – Advancing E-Cancer Reporting and Registry Operations (NPCR-AERRO): Implementing Electronic Pathology Reporting From a National Laboratory to Multiple State Cancer Registries

The National Program of Cancer Registries-Advancing E-Cancer Reporting and Registry Operations (NPCR-AERRO) is a collaborative project within the CDC-NPCR to position the cancer surveillance community to take advantage of the electronic health record (EHR) for cancer surveillance. A pilot project was initiated with a large national laboratory and 18 central cancer registries (CCR) to transmit pathology reports to cancer registries using the approved North American Association of Central Cancer Registries HL7 implementation guide. NPCR-AERRO staff worked with the laboratory to develop the message and test the implementation of the NAACCR-approved HL7 implementation guide for electronic pathology laboratory reporting and associated business rules. Several tools including PHIN-MS, eMaRC, and Messaging Workbench have been used. The approach to require all pathology reports to be submitted to the appropriate CCR, regardless of whether the diagnosis is reportable, had to be reevaluated due to privacy and workload issues raised by states and laboratories. Ultimately each registry will need to decide whether to require reporting laboratories to submit all reports or to specify the relevant reports. CDC-NPCR worked with the laboratory to establish the appropriate filtering option to identify reportable cancer case reports. This presentation will share lessons learned in the use of tools, legal issues, and filtering methods; provide an update on current status of the project; and describe future plans to expand e-Path reporting to additional US national laboratories and other CCRs.