California Experiment Will Let Pathologists Report Cancer Diagnoses in Real Time

A collaborative pilot that involves the California Department of Public Health, St. Joseph Health in Orange County, and UCSF Benioff Children’s Hospital in Oakland is studying whether near—real-time reporting of cancer diagnoses by pathologists, using standardized electronic forms, will permit providers to make more informed and timely treatment decisions.

As part of the project, pathologists at a dozen hospitals in the state will document cancer diagnoses to the California Cancer Registry as soon as it is possible, quite unlike the traditional method which often saw reliance on data that could be as much as 2 years old. According to the report by Kaiser Health News (KHN), the registry is a treasure trove of information—diagnoses, screening, patient demographics, initial treatments, and outcomes—on over 4.5 million cancer patients. With access to more real-time information, oncologists would be better situated when choosing treatment options for their patients.

This also opens up a window of opportunity for directing patients to the appropriate clinical trial. “Our driving force is making sure we can get the patient to the right treatment, the right trials as quickly as possible,” Michelle Woodley, chief nursing information officer at St. Joseph Health System, told KHN.

The most significant impact of adding this capability to the registry is the potential for prospective analysis, instead of retrospective analysis that researchers have resorted to with the database. The California Cancer Registry is often used by researchers to identify disparities in cancer screening and outcomes as well as to confirm hot spots of specific cancer types. While such information is very useful for population-based surveillance studies, they may not be as efficient when providing more individualized care.

Bob Achermann, executive director of the California Society of Pathologists, told KHN, “The current system is not working as well as it should. There are long delays…You would assume that a program that has been around as long as it has would be more sophisticated, but it is not.” While the state mandates reporting of all cancer diagnoses, it wants real-time reporting to increase to 10% by next June, from the current 5%, and to 65% by 2022.

Transition from paper charts to electronic health records and an upgrade to information systems used by hospitals and cancer clinics could provide a significant boost to this project. Programs are also being piloted to make it easier for pathologists to provide their diagnoses—such as creating a checklist instead of a summary paragraph for easier interpretation.

The California Department of Public Health, meanwhile, hopes to expand such programs statewide. “As technology in every aspect of our lives has drastically changed, so has the expectation of physicians, laboratories, facilities and facility groups about what types of data they need,” said a statement released by the department.