Meaningful Use


Meaningful Use (MU) Cancer Reporting is intended for eligible providers (EPs) who diagnose and/or treat cancer. The information collected comes from the Electronic Health Record (EHR) and is transmitted to the registry. To submit cases to the NCCR, the EHR must have the technology that has been certified by an Office of the National Coordinator for Health Information Technology (ONC). Authorized Testing and Certification Body to create and transmit case reports must be in accordance with the Implementation Guide for Ambulatory Healthcare Provider Reporting to Central Cancer Registries, August 2012 or the Implementation Guide for Ambulatory Healthcare Provider Reporting to Central Cancer Registries, HL7 Clinical Document Architecture (CDA), Release 1.1, March 2014  

  • EPs must ensure their EHR software is certified by ONC to collect and submit cancer information to a registry

  • EPs must register their intent for MU with the NCCR (Appendix M)

  • EPs is placed on hold until the NCCR is ready to on-board the provider

  • Testing and validation process begins

  • Confirmation of ongoing submission

  • MU Registration Form
  • Provider Checklist for Achieving MU

MU Stage 2 Guidance

    Guidance for Eligible Professionals Participating in the Meaningful Use Stage 2 Cancer Reporting Objective

    The Nevada Central Cancer Registry (NCCR) collects information about cancer cases diagnosed and/or treated in Nevada as mandated by Nevada Public Health Law. Historically, cancer cases have been reported by hospitals. Increasingly, patients diagnosed with cancer are being treated by ambulatory care providers in the outpatient setting. The Meaningful Use Stage 2 (MU2) cancer case reporting objective provides a mechanism for these providers to electronically report their cancer cases. Public health cancer registry surveillance data are used for describing the occurrence of cancer in a given population, assessing cancer mortality and patient survival, development of comprehensive cancer control programs, healthcare planning and interventions, and research.

      Diagnosis or Direct Treatment of Cancer

      The cancer case reporting objective is intended only for Eligible Professionals (EPs) who diagnose and/or directly treat cancer. The cancer case reporting objective is not a menu option for Eligible Hospitals. EPs must diagnose or treat cancer in order to select the cancer reporting objective. A diagnosing physician is one who definitively diagnoses cancer. If physician A refers a patient to physician B for further work-up and confirmation, the NCCR would not consider physician A as the diagnosing physician. The NCCR considers a physician who directly treats cancer as one who performs/administers treatment modalities (i.e., surgery, radiation, chemotherapy, immunotherapy, and hormonal therapy) directed at the cancer. Additionally, a treating physician could be one who decides (with the patient) that there will be no treatment given/received. Physicians who do not diagnose or directly treat cancer should select other menu objectives and may claim an exclusion for the cancer reporting objective.

        Cancer Case Report Creation and Transmission

        To submit cancer cases for MU2, your EHR must have the technology that has been certified by an Office of the National Coordinator for Health Information Technology (ONC) - Authorized Testing and Certification Body to create and transmit case reports in accordance with the Implementation Guide for Ambulatory Healthcare Provider Reporting to Central Cancer Registries (August 2012)To determine if your software is certified for the cancer reporting ((§170.314(f)(5) Cancer Case Information and §170.314(f)(6) Transmission to Cancer Registries) visit the Certified Health IT Product List (http://oncchpl.force.com/ehrcert/CHPLHome).Clicking on the “2014 Edition” button will open a page which provides various search options. Click on the “Criteria Met” search button, scroll down and check the boxes in front of (f)(5) Cancer Case Information” and (f)(6) Transmission to Cancer Registries), and then click the “Search Matching Products” button. A list of all ONC Certified products for Cancer Reporting will be displayed.

        The NCCR requires secure file transfer protocol (sftp) to be used for submitting the cancer reports to the central cancer registry. Please consult with your EHR vendor for assistance with transport if needed.

          What type of information is included in a cancer report to the Nevada Central Cancer Registry?

          The information usually collected for cancer registry reporting is quite extensive. Information collected for a cancer case report includes but is not limited to the data elements in the table below. Ideally, all this information about your cancer patient will be collected or contained in your Electronic Health Record (EHR) to create and transmit a cancer case report. The cancer case information is captured as part of provider workflow processes and submitted as part of the cancer case report. Although the data elements in the table below are necessary for a complete cancer case report, NCCR expects report submission even for cases where some data elements are not available. The cancer registry will work with EPs during the onboarding process to identify data availability, key data elements, and other issues.

            Types of Information included in a Cancer Report to the Nevada Cancer Registry
            Data Element Importance to Public Health Cancer Surveillance
            Patient Information
            • Last Name, First Name, Middle Initial
            • Date of Birth
            • Address, City, State, Zip Code
            • Address History
            • Social Security Number
            • Sex/Gender
            • Race, Ethnicity
            • Occupation, Industry
             
            Detailed patient information is necessary for consolidation of multiple case reports received from multiple sources for the same person over time. Much is also needed to produce information about cancer incidence and mortality by age, gender, race, ethnicity, geographic region. These data elements are generally collected and maintained in EHRs as part of workflow processes and are used for patient identification for sharing data through health information exchanges.
            Provider/Organization Information
            • Physician and Organization Name, NPI, Address, Phone #, Specialty
            • Provider referred from/to
            • Patient's Medical Record #
             
            Information about physicians that participate in the care of the patient, at any time from diagnosis through treatment, allows registries to obtain more complete cancer reports.
            Cancer/Tumor Information
            • Primary Site
            • Histology
            • Diagnosis Date
            • Behavior
            • Laterality
            • Method of Diagnosis Confirmation
            • Clinical TNM Stage
             
            Detailed tumor information is necessary for consolidation of multiple case reports from multiple sources for the same tumor received over time. Much of this information is very specific and related tot he cancer at the time of diagnosis and is generally found within a pathology report.
            Treatment Information
            • Procedures
            • Medications, Medications Administered
             
            Collection of information related to cancer-directed treatment is necessary for assessing cancer treatments and outcomes and access to care. This information is captured as part of the practice workflow processes and submitted as part of the cancer case report.

              Testing and On-Boarding Prioritization

              Among those Eligible Professionals (EPs) who register the intent to submit cancer data, the NCCR will necessarily prioritize for testing and on-boarding based on criteria including, but not limited to, provider specialty. Specialties such as dermatology, urology, hematology, medical oncology, and gastroenterology, where cancer diagnosis and/or treatment frequently occur in the outpatient setting, are among those that will be given high priority for testing and on-boarding. Other EPs will be placed in a queue to await invitation from the cancer registry. EPs who have an existing organizational relationship with a hospital, radiation treatment center, or ambulatory surgery center that already reports to the NCCR will be given lower priority and their MU reporting is not intended to replace already existing facility reporting. The established cancer reporting is expected to continue uninterrupted, whether or not the EP registered for MU2 or participated in the on-boarding process.

                Questions

                For questions about the Nevada Central Cancer Registry or cancer reporting, please email cpool@health.nv.gov. The NCCR can provide information specific to cancer reporting but cannot provide information or advice about the Centers for Medicare & Medicaid Services (CMS) MU2 attestation process. For questions about the registration process, please contact [Insert contact information]. For more information about the CMS MU program, please see CMS EHR Incentive Programsat http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/index.html.

                  Useful Links for Meaningful Use 2

                  • Health level 7 International
                  • Clinical Document Architecture, Release 2 Information
                  • CDC Guidance at the National Program of Cancer Registries
                    • Implementaion Guide for Ambulatory Healthcare Provider Reporting to Central Cancer Registries, HL7 Clinical Document Architecture
                    • Cancer Reporting Clarification Document for Electronic Health Record (EHR) Technology Certification
                    • CDA Validation Plus Tool Software and Training Manual
                  • Checklist for Achieving MU for Cancer Reporting
                  • Transport Options
                  • Public Health Reporting Task Force
                  • Meaningful Use Implementaion Guide for Vendors to Insure Successful EHR Implemnation