The National Cancer Institute (NCI) has developed explicit guidelines for cancer screening of the asymptomatic population in an effort to promote early detection and treatment. Various organizations, including the applicant, have made progress with the use of computer technology to support cancer screening, especially for generation of customized reminder letters and scheduling of initial and repeat screening activities. However, even these efforts do not produce consistent levels of adherence in the general population. Moreover, none of the systems specifically address the clinical follow-up of patients with abnormal findings. Rosen Associates proposes to build on its experience in developing tracking and follow-up systems for cancer screening, with the goal of providing a computer software package that will foster dependable follow-up and reliable patient tracking. The research will begin with a review of existing software. The researchers will identify impediments to uniform care through a program of interviews and meetings, and develop an enhanced software design specifically aimed at surmounting those barriers. This design will then be implemented and the resulting software will be tested and evaluated in a hospital environment. Requirements for extending the software to support other environments and their existing patient databases will be identified.
