Tag Archives: cancer registrar

What’s in a Name? Is “Tumor Registry” an Outdated Term?

By Holly J. Kulhawick, CTR

Jigsaw puzzle question mark-smThe National Cancer Registrars Association (NCRA) recently asked members on its Facebook page, “Is tumor registry an outdated term?” The responses were spirited and detailed the ways tumor registry and the Certified Tumor Registrar (CTR) credential can be confusing. For example, NCRA members noted that some of their colleagues and patients think they help patients register for treatment or that a CTR “certifies” tumors. There was a strong sense that the current terminology belittles what cancer registrars do, or gives the impression the work is less technically sophisticated than it is. In a time when registrars are struggling to defend the profession from automation and the fear that this automation will compromise data quality, the Facebook discussion suggested the time has come for the profession to revisit its terminology.

First, the term tumor is outdated on a number of fronts. Cancer registrars track more than tumors. They collect information on blood cancers and some benign and premalignant conditions. Second, the term tumor registrar is confusing. What does a “tumor registrar” do? A more descriptive term, such as Oncology Data Analyst or Oncology Data Manager, explains in three words the actual work of a registrar. Many NCRA members suggested this would help to emphasize the analytical aspects of the job and allow them to highlight to hospital administrators the role they play in supporting the cancer program and other oncology support services. Some facilities are already taking the lead, re-naming their Cancer Registry Department as the Oncology Support Services Department and updating their staff titles to Data Analysts. For some real-world examples of how CTRs can support an organization’s cancer program read “Unlock the Potential of the Cancer Registrar” (Oncology Issues, January/February 2016).

The Facebook posts also noted that the lack of clarity associated with “tumor registrar” does not help a profession that struggles to be recognized. A clear, concise title would go a long way to help elevate the work in the eyes of other health professionals. A change in terminology may also help with the Physician Quality Reporting System (PQRS), which is a quality reporting program that encourages individual eligible professionals and group practices to report information to Medicare on the quality of care. A title such as Oncology Data Analyst or Oncology Data Manager flags the cancer registrar as someone who can assist with PQRS requirements, helping to advance the role of the registrar.

A name change would also help with the general public. Some registrars noted that they have spent time explaining to patients that they are not the hospital staff to help them register for chemotherapy. A more direct or clear term would help to eliminate this confusion. The concept of registration—while reflecting accurately the work of a CTR—makes some patients nervous. When they learn they are part of a large cancer registry, they want no part of it, believing it is too much government oversight. If the terminology were changed to Oncology Data Analyst or Oncology Data Manager, it might better convey that skilled and certified professionals are collecting the data and its use is highly regulated and needed to advance cancer care and treatment.

The Facebook discussion suggested there is strong agreement on possible new terminology: Oncology Data Analyst or Oncology Data Manager. But what are the next steps? The National Cancer Registrars Association (NCRA) established a task force in 2008 to study the issue. At that time, there was insufficient member support to make a change. If members want to bring the issue to the forefront again, they can use NCRA’s formal process for members to be heard through its Advocacy and Technical Practice Directors (ATPDs). These board members serve as the liaisons between members and NCRA on matters of advocacy and technical practice. Interested members can go to the Raise Your Voice webpage to contact their ATPD to get the process started.

Guest blogger Holly J. Kulhawick, CTR, is Remote Abstractor for HCA/Methodist Healthcare San Antonio and Flatiron. 

Learn more about the pivotal role your cancer registry can play in supporting your cancer program, during a session on how to “Improve Your Data Collection—Streamline Your Accreditation & Quality Reporting Processes” at the upcoming ACCC 43rd Annual Meeting, CANCERSCAPE, March 29-31, in Washington, D.C.  Read the full agenda here


8 Ways Your Cancer Registry Can Support Your Cancer Committee

by Linda Corrigan, MHE, RHIT, CTR

Check boxCommission on Cancer (CoC)-accredited facilities must establish a cancer committee and charge it to develop and monitor all cancer program activities and cancer-education initiatives. The CoC Cancer Program Standards require that the cancer committee has multidisciplinary representation that includes physicians, other allied health professionals, and a cancer registrar.

Cancer registrars play a critical role on the cancer committee, since they are the only member who has a complete picture of the facility’s cancer burden in their database. The cancer registrar can serve as the committee’s data expert by analyzing data and bringing those findings to the committee for use in program planning. Here are eight ways in which cancer registrars can support their organization’s  cancer committee in meeting CoC Standards, and more:

  • Standard 1.12 Public Reporting of Outcomes is a commendation standard that lists seven possible other standards that can be included and at least three of these are based on cancer registry data. Accountability and quality measures are regularly reviewed by the cancer committee and your registrar may provide guidance on which measures demonstrate the best outcomes.
  • Standard 2.1 CAP Protocols and Synoptic Reporting. Most cancer registry databases can be set up to track CAP synoptic summary adherence, allowing the cancer registrar to provide an important piece of needed data.
  • Standard 3.3 Survivorship Care Plans. Procedures can be established such that the registrar and nurse navigator work as a team to implement and monitor survivorship care plans (SCPs). In many cases, the registry data can be downloaded directly to create and update the SCP, saving the nurse navigator hours of work and ensuring these plans are up-to-date and patients are kept informed.
  • Standard 4.1 Prevention Programs target risk factors that contribute to a diagnosis of cancer. Effective prevention programs start with data, which can be community-wide data or facility-specific data. Either way, your cancer registrar can assist with data collection and also search the CoC Cancer Forum for examples of best practices for this standard.
  • Standard 4.2 Screening Programs start with data. Your cancer registrar can create graphs to illustrate and explain which sites of cancer present to your facility at an advanced stage at diagnosis. Then the cancer committee can discuss whether there is an evidence-based intervention your facility could implement to diagnose these cancers earlier. Your registrar may also be able to assist with collecting this screening data and the subsequent lower stage at diagnosis.
  • Standard 4.6 Monitoring Compliance with Guidelines. To help meet this requirement, the cancer registrar can look at how many breast cancers are being treated in accordance with the National Comprehensive Cancer Network (NCCN) guidelines and identify the cases not meeting the recommendations.
  • Help with the recruitment of new physicians by providing data on the number of cancer sites diagnosed at the facility. For example, a hospital with a high-volume of lung cancer diagnoses may consider hiring more specialists or establishing a lung cancer institute to meet the community’s needs. Registrars can also evaluate in- and out-migration patterns to help hospital administration understand and address patient-retention patterns. For example, if a patient is diagnosed at the facility, but seeking care and treatment elsewhere, this might be an indication that the facility-of-diagnosis does not have the specialists on staff to address patient care. Registrars can also analyze the time from diagnosis to treatment or from biopsy to final surgery to help the cancer committee spot where improvements can be made. Registrars can also review the distances patients travel for their care, what insurance they carry, and other factors that can be barriers to care.
  • Serve as a resource on CoC standards by reporting on information learned at the National Cancer Registrars Association’s annual conference. The CoC offers a standard Q&A session at this conference, providing an opportunity for cancer registrars to better understand the intent of the standards and clarify any questions. For example, in 2016 Daniel McKellar, MD, FACS, chair of the Commission on Cancer, explained which standards surveyors are reporting as being “noncompliant” and how to make sure your program is compliant on those standards. This was vital information that attending registrars brought back to their cancer committees.

Your cancer registry is a valuable resource for your cancer committees,  housing the data needed to help meet CoC standards and ensure patient-centered care. Key to success, however, is a cancer registrar who knows how to analyze and present the data. Hiring registrars who hold the Certified Tumor Registrar (CTR) credential is a good first step, but providing ongoing training on advancements in cancer treatments and data analysis and informatics is critical.

Contributing blogger ACCC Member Linda Corrigan, MHE, RHIT, CTR, is currently serving as President of the National Cancer Registrars Association.


Tap Into the Expertise of Your Cancer Registrar

By Linda Corrigan, MHE, RHIT, CTR

ThinkstockPhotos-507273299Hospitals understand their cancer registry data are sent to state and federal agencies to document incidence rates and to identify cancer clusters. But many may not be realizing the full potential of their cancer registry database, a goldmine full of information that can help your facility. Hospital-specific data provide a wealth of information that can assist with financial and strategic planning, assessing timeliness of treatment, understanding survival rates, conducting community needs assessments, and implementing targeted marketing initiatives.

As the custodians of your data, cancer registrars know it better than anyone and can see trends as they happen. Make sure to include your cancer registrar in meetings and ask for updates. Tap into your cancer registrar’s expertise and put your data to work. Your cancer registrar can:

  • Help your program justify additional staff. For example, by monitoring case volume by site, year, and insurance coverage, your cancer registrar can supply data to make the case for adding physicians to your cancer program.
  • Run reports to identify patterns (or specifics) about who is seen in your cancer program by identifying referring physicians or hospitals. These data can help track trends in patient retention as well as outmigration.
  • Assist with quality improvement/process improvement initiatives. For instance, time to treatment is a frequent target for cancer program improvement efforts. Your cancer registrar can do a deep data dive into your patient population and uncover the exact profile of those patients experiencing the greatest delays.
  • Collect specific data to generate custom reports through user-defined fields in the database. What data do you want to collect? Many registrars have already started reviewing patients seen in the beginning of 2016, so now is the time to talk with your cancer registrar about any additional data you may need for future reports.
  • Compare your data (demographics and disease-site specific data) to that housed in several other national databases.
  • Support your Cancer Committee with data that identifies your patient population and specific health disparities in your service area as the triennial Community Needs Assessment is being completed.

These are just some of the many ways the expertise of your cancer registrar can support your cancer program. An upcoming ACCCBuzz blog post will explore the evolving role of cancer registrars and how your oncology program can support registrars as an integral member of the cancer care team.

ACCC Member Linda Corrigan, MHE, RHIT, CTR, is currently serving as President of the National Cancer Registrars Association.  Learn about the NCRA Annual Education Conference, April 5-7, 2017, here.  Explore NCRA’s Center for Cancer Registry Education here.  The January/February 2016 Oncology Issues features, “Unlock the Potential of the Cancer Registrar,” an article co-authored by Ms. Corrigan that describes how cancer registrars can support lung screening programs within community cancer centers.