North American Association of Central
Cancer Registries, Inc.
Comparing Standards for Cancer Registries Volume V:
Pathology Laboratory Electronic Reporting Version 4.0
with
HL7 Version 2.5.1 Implementation Guide:
Electronic Laboratory Reporting to Public Health, Release 2 (US Realm), Draft Standard for Trial Use, Release 1.1
“The Electronic Laboratory Reporting (ELR) Comparison Document”
November 3, 2015
Table of Contents
1Introduction 7
1.1Problem Statement, Goal, and Scope of this Document 7
1.1.1The Problem 7
1.1.2The Goal 7
1.1.3Audience 7
1.1.4 The Scope of this Document 8
1.2Differences between Volume V, Version 4.0 and ELR R2 (DSTU R1.1, U.S. Realm) 8
2Summary of Differences 9
3Recommendations 22
4Appendix A. Data Types Referred to in this Document 23
5Appendix B. Acronyms and Key Words 24
ELR Messaging Comparison Task Force
of the NAACCR
Standardization and Registry Development Steering Committee
2014-2015
Jovanka Harrison, PhD (Chair)
New York State Cancer Registry
Phone: (518) 474-2255
E-mail: jovanka.harrison@health.ny.gov
Lori A. Havener, CTR
NAACCR
Phone: (217) 698-0800
E-mail: lhavener@naaccr.org
Victor Brunka
Artificial Intelligence in Medicine
Phone: (416) 594-9393
E-mail: vbrunka@aim.ca
Jagdeep Gill
Artificial Intelligence in Medicine
Phone: (416) 594-9393
E-mail: jgill@aim.ca
Sandy Jones
CDC/NPCR
Phone: (770) 488-5689
E-mail: sft1@cdc.gov
Ted Klein
Klein Consulting, Inc.
Phone: (631) 924-6922
E-mail: ted@tklein.com
Gemma Lee
Cancer Care Ontario
Phone: (416) 971-9800
E-mail: gemma.lee@cancercare.on.ca
Nicola Schussler
Information Management Services (IMS), Inc.
Phone: (301) 680-9770
E-mail: schusslern@imsweb.com
Preface
In January 2014, we completed the “Standards for Cancer Registries Volume V: Pathology Laboratory Electronic Reporting: Supplement” document, not realizing that change was already occurring in the domain of electronic laboratory reporting to public health entities, and that a need for another ‘comparison’ type document (i.e., gap analysis document) was percolating. The “Supplement” addresses the updates and changes introduced in two North American Association of Central Cancer Registries (NAACCR) standards: the older one, Volume V, Version 2.2, compared with the newer standard, Volume V, Version 4.0, “the Current Registry Standard”.
In May 2014, Health Level Seven International (HL7), a standards setting organization (http://www.hl7.org) published an implementation guide (HL7 Version 2.5.1 Implementation Guide: Electronic Laboratory Reporting to Public Health, Release 2 (US Realm), Draft Standard for Trial Use (DSTU), Release 1.1), “the Draft Standard”, providing updated guidance for laboratories reporting to public health entities. The intent of a DSTU is to gather comments from the field to be applied towards a future and final standard. Changes proposed in the Draft Laboratory Standard, or the Electronic Laboratory Reporting (ELR) guide, as it is sometimes also referred to, may have implications for the NAACCR community. Central cancer registries in the U.S. and Canada use NAACCR Standards for Cancer Registries Volume V as the e-path standard. In the U.S., central cancer registries often rely on the infrastructure that comes with the Public Health Information Network (PHIN) supported system, and they leverage ELR implementations of many laboratory systems. Implementation guides that require stakeholders to implement different messaging interfaces could be costly, and negatively impact standardization of cancer reporting, in both countries. Therefore a gap analysis was needed. This ELR comparison document is the result of that gap analysis.
The specific aim is to inform and alert potential implementers, such as enterprise architects, interface developers, cancer registry administrators, and technical staff as to the differences between NAACCR Standards for Cancer Registries Volume V, Version 4.0 (the Current Registry Standard) and the ELR guide (the Draft Laboratory Standard). These differences may have various degrees of significance, from minor to major, the latter potentially jeopardizing the flow of data from pathology laboratories to central cancer registries and the ability of central cancer registries to perform their primary function. All such differences are documented here.
The NAACCR ELR Messaging Comparison Task Force (TF) members hope that this document will be of use to the entire NAACCR community interested in standards and involved in the transmission and receipt of electronic pathology reports. Our goal is to continue to provide resources that will support the transmission and collection of reliable, accurate, and timely pathology reports of cancer diagnoses, while minimizing duplication of effort.
As the Chair of the ELR Messaging Comparison TF, I would like to acknowledge the dedicated members of TF, especially Ted Klein (for overall guidance and technical support), for their time, effort and dedication in the production of this document.
Sincerely,
Jovanka Harrison
ELR Messaging Comparison Task Force Chair
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