We present a path towards single-source tumor documentation established at the Comprehensive Cancer Center Erlangen-Nürnberg (CCC-EN). Our goal was to derive data for cancer quality assurance and certification, cancer registry documentation and cancer research directly from routine care documentation. Therefore, clinical documentation activities were analyzed and a cancer data superset, containing these required elements, was developed. This superset was then split into appropriate clinical documentation packages, and the existing information technology infrastructure was analyzed and adapted to accommodate those documentation packages. A clinical documentation package is the amount of cancer-relevant data that can be captured within a clinical encounter. This grouping of data enables integration into existing clinical documentation workflows. We present examples in which single-source tumor documentation has been successfully established at the CCC-EN. The resulting cancer documentation reference model is described and its transferability to other institutions discussed.

Keywords:
Tumor documentation, Cancer, Single-source, Information technology, Dataset
1.
Boyle P, Levin B: World cancer report. Lyon, IARC Press, 2008.
2.
Eschenbach AC, Buetow K: Cancer inform: caBIG™. Cancer Informatics 2006;22:22-24.
3.
Califano A, Chinnaiyan AM, Duyk GM, Gambhir SS, Hubbard T, Lipman DJ, Stein LD, Wang JY, Bartlett OT, Harris CL: An assessment of the impact of the NCI Cancer Biomedical Informatics GRID (caBIG); 2011. http://arc.georgetown. edu/BSAcaBIGAssessment.pdf.
4.
Bilimoria KY, Stewart AK, Winchester DP, Ko CY: The National Cancer Data Base: A powerful initiative to improve cancer care in the United States. Ann Surg Oncol 2008;15:683-690.
5.
Australian Government: A National Cancer Data Strategy for Australia. Barton. http://www.cancer-australia.gov.au/sites/default/files/user-upload/ publications/ncds_final_web.pdf
6.
Grundmann E, Wagner G, Hermanek P, Wächter W, Altmann U, Dudeck J: Basisdokumentation für Tumorkranke, 5th ed. München, Zuckschwerdt, 1999.
7.
Does the UK really have an effective cancer plan? Revisited. Lancet oncol 2009;10:305.
8.
Evrard S: Enhancing patient safety and quality of surgical cancer care: The French National Cancer Plans. Eur J Surg Oncol 2010;36:S14-17.
9.
Zylka-Menhorn V: Nationaler Krebsplan: Startschuss für einen mehrjährigen Prozess. Dtsch Arztebl 2008;105:A-1431.
10.
Beckmann K, Jud S, Heusinger K, Schwenk M, Bayer C, Häberle L, Beckmann MW: Dokumentation in der gynäkologischen Onkologie. Gynäkologe 2010;43:400-410.
11.
Datensparsame einheitliche Tumordokumentation - eine Kernforderung des Nationalen Krebsplans. Berlin, Bundesministerium für Gesundheit, 2011. http://www.bmg.bund.de/fileadmin/dateien/ Downloads/N/Nationaler_Krebsplan/Papier_zur_Tumordokumentation_101011.pdf
12.
Beckmann MW, Brucker C, Hanf V, Rauh C, Bani MR, Knob S, Petsch S, Schick S, Fasching PA, Hartmann A, Lux MP, Häberle L: Quality assured health care in certified breast centers and improvement of the prognosis of breast cancer patients. Onkologie 2011;34:362-367.
13.
Altmann U, Katz FR, Dudeck J: A reference model for clinical tumour documentation. Stud Health Technol Inform 2006;124:139-144.
14.
Ries M, Golcher H, Prokosch H, Beckmann MW, Bürkle T: An EMR based cancer diary - Utilisation and initial usability evaluation of a new cancer data visualization tool. Stud Health Technol Inform 2012.
15.
Mate S, Bürkle T, Köpcke F, Breil B, Wullich B, Dugas M, Prokosch H, Ganslandt T: Populating the i2b2 Database with heterogeneous EMR data: A semantic network approach. Stud Health Technol Inform 2011;169:502-506.
16.
Ganslandt T, Mate S, Helbing K, Sax U, Prokosch H: Unlocking data for clinical research - The German i2b2 experience. Appl Clin Informatics 2011;2:116-127.
17.
Chahal AP: Informatics in Clinical Research in Oncology. Cancer J 2011;17:239-245.
18.
Lau EC, Mowat FS, Kelsh MA, Legg JC, Engel-Nitz NM, Watson HN, Collins HL, Nordyke RJ, Whyte JL: Use of electronic medical records (EMR) for oncology outcomes research: assessing the comparability of EMR information to patient registry and health claims data. Clin Epidemiol 2011;3:259-272.
19.
Ochs MF, Casagrande JT: Information systems for cancer research. Cancer Invest 2008;26:1060-1067.
20.
Kunz I, Lin M, Frey L: Metadata mapping and reuse in caBIG BMC Bioinformatics 2009;10 Suppl 2:S4.
21.
Papatheodorou I, Crichton C, Morris L, Maccallum P, Davies J, Brenton JD, Caldas C: A metadata approach for clinical data management in trans- lational genomics studies in breast cancer. BMC Med Genomics 2009;2:66.
22.
Sioutos N, de Coronado S, Haber MW, Hartel FW, Shaiu W, Wright LW: NCI Thesaurus: A semantic model integrating cancer-related clinical and molecular information. J Biomed Inform 2007;40: 30-43.
23.
Zünkeler M, Schlag PM: Regionale Verbünde in der Onkologie. Onkologe 2009;15:1070-1081.
24.
Lordick F, Beiglböck A, Jäger D, Siewert JR: Multidisziplinarität im Cancer Center; in: Siewert JR, Rothmund M, Schumpelick V (eds): Praxis der Viszeralchirurgie, 3rd ed. Berlin, Springer-Verlag, 2010, pp 201-211.
25.
Brucker S, Krainick-Strobel U, Bamberg M, Aydeniz B, Wagner U, Du Bois A, Claussen C, Kreienberg R, Wallwiener D: Brustzentren. Rationale, funktionelles Konzept, Definition und Zertifizierung. Gynakologe 2003;36:862-877.
26.
Brucker S, Traub J, Krainick-Strobel U, Schreer I, Kreienberg R, Bamberg M, Jonat W, Wallwiener D: Brustzentren—Entwicklung in Deutschland. Onkologe 2005;11:285-297.
27.
Seegenschmiedt M, Karstens J: Wesentliche Instrumente in der Qualitätssicherung onkologischer Einrichtungen. Onkologe 2005;11:1253-1268.
28.
Zemlin C, Herrmann-Lin gen C, Wiegard K, Kleiber C, Kolb-Niemann B, Lubbe D, Schade-Brittinger C, Wagner U, Albert US: Implementation of a computer and screening-based psychooncological clinical pathway. Geburtsh Frauenheilk 2011;10:853-861
29.
Dugas M, Lange M, Muller-Tidow C, Kirchhof P, Prokosch H: Routine data from hospital information systems can support patient recruitment for clinical studies. Clin Trials 2010;7:183-189.
© 2013 S. Karger AG, Basel
2013
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.