Transmission of Cancer Abstract Reports Using HL7's CDA

The priority of the North American Association of Central Cancer Registries, Inc. (NAACCR) is to attain interoperability with national standards organizations.  NAACCR is an association of central cancer registries in North American and since the early 1990s has developed standards for the transmission of cancer abstract reports.  While these standards enable a network of cancer registries throughout the country to report approximately 1.2 million cancers on an annual basis, there are limitations to the fixed-width, column-delimited format. 

Over the past several years, NAACCR explored alternative formats for the transmission of the cancer abstract report as described in Standards for Cancer Registries, Volume II, Data Standards and Data Dictionary.  Currently this format is fixed-width and column-delimited.  While this format has served the registry community well and enabled the transmission of standardized data between registries, there are limitations of limited length of text-data and inconsistency with national health information technology standards.  After examining a variety of possible formats and applying selection criteria, it was decided HL7’s CDA format was the most appropriate.  In order to test the validity and utility of this format in the cancer registry community, the NAACCR initiated a pilot test to transmit cancer registry data from a hospital cancer registry to a central cancer registry. 

This presentation will 1) outline the business applications of cancer registration; 2) introduce HL7’s CDA; 3) explain the pilot project protocol; 4) highlight the CDA implementation guide; 5) describe a model for concurrent implementation of both the CDA format and the column-delimited format; and 6) review the report to the NAACCR Board of Directors.  HL7’s CDA is an emerging standard for electronic health records; its adoption could present the opportunity for NAACCR data messages to be consistent with an international standards organization.