This is an exploratory study to assess the feasibility of implementing electronic capture of missing cancer surveillance data on chemotherapy treatment from the claims billing stream in community oncology practices. The investigators will modify and test a system developed at Virginia Commonwealth University and currently used in case ascertainment, to capture treatments and information on follow up for the cancer registration process. The modified software application will automatically review all outgoing electronic claims from participating oncology practices and capture relevant information on cancer cases and their chemotherapy treatment. This exploratory study will be performed in three community oncology practices in Virginia. The sample is selected as a convenience sample to provide preliminary information on the level of variability in electronic data submission systems from practice to practice and to provide information to assess the degree of modification that will be required to implement the existing software across different practices. The practices vary in location, number of physicians and the level of electronic medical record integration existing in the practice. Once the application is installed at the practice, all claims submitted during a three month study period will be electronically screened. All patients with claims including a CPT code for chemotherapy during the study period will be captured. The system will then send the information in a secure, encrypted and HIPAA compliant manner to the central cancer registry. The claims data will be matched with existing registry data to identify cases and chemotherapy treatments missing from the registry. In addition, there will be a manual review and abstraction of medical records for all patients not reported to the central registry and a sample of patients with and without chemotherapy reported to the central registry and identified through claims. The number of newly identified incident cases and the frequency and characterization of these missed cases and all chemotherapy (not captured in the central registry) will be assessed. This study will provide information to evaluate the feasibility and quantitative benefit of a community oncology practice-based supplemental surveillance system, including practical information related to the costs and level of effort that would be required to implement such a program. It will offer information to direct strategy for the next steps in implementing such a system on a more comprehensive basis. This study has the potential to enhance cancer surveillance information collected at many levels including central registries and SEER by addressing a significant deficit in available data-information on chemotherapy treatment. Testing the feasibility of utilizing an existing resource (billing information) to automate the capture of detailed data on chemotherapy from physician practices is an important step towards filling that information gap.
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