As part of our ONCOLog 4.5.0 release earlier this year, there were multiple field groups released to help our clients track Commission on Cancer (CoC) Standards, track delays in treatment, and assist CTRs with organizing their workload. These fields were evaluated by our in-house CTR staff to ensure they could easily be utilized by clients and are housed in a logical place within the abstract.
One of the field groups added to ONCOLog was a group of 8 fields called ‘Case Pending Additional Treatment (Incompletes)’ located in the Treatment Supplemental section of the abstract. These fields were created to help manage charts pending additional information before they are truly complete. Before we review some examples, let’s look at the fields themselves.
Case Pending Additional Treatment: This combo field serves as the main field to identify whether the case is pending additional treatment. Options are Yes, No, and N/A. Can be defaulted to ‘No’ in Admin.
Type of Info Pending: This is a multi-select field used to identify the type of information pending at the time of initial abstract. Options are diagnosis-related info, staging, biopsy info, surgery info, chemotherapy info, radiation info, hormone therapy info, immunotherapy info, and treatment complete – waiting on outside medical record info.
Date of Expected Completion: This is a date field used in conjunction with the fields above to estimate when the abstractor thinks the information will be in the EMR or returned from a practice or facility. The idea is that this would always be a future date. For example, if a patient was expected to complete their RT on 12/1/20, you could put estimated completion date to 12/8/20 and review the case for an end of treatment note on 12/8. If the note is not available, you would then push your estimated completion date out a week (12/15) and re-check.
Abstractor Waiting on Treatment: A text field that could be used as name, initials, abstractor code, etc. While we thought about utilizing Abstracted By, we considered that some facilities may use one centralized person to review and complete ‘incomplete’ cases so wanted to give clients flexibility on who to ‘assign’ the treatment follow-up to.
Date Treatment Letter Sent and Date Treatment Letter Received: For those facilities sending treatment letters, there are date fields to track when a treatment letters was sent and a field to track when (or if) the treatment letter was received back.
Physician Letter Sent To: A text field to track which practice(s) a treatment letter was sent to.
Additional Detail: Open ended text field allowing for any additional details or notes the staff would like to collect.
Now that we’ve covered the fields available, let’s review a couple examples of situations where these fields could be utilized.
Example 1: A CTR completes a breast chart on 12/1/20, 4 months after date of first contact. Surgery has been completed, chemo is underway, and the patient’s treatment plan or treatment guidelines recommend RT and hormone therapy at the conclusion of chemotherapy. CTR codes Case Pending Additional Treatment Information = Yes; Type of Info Pending = Radiation Info, Hormone Therapy Info. Date of Expected Completion = Set for 2/15/21 (expecting another two months of chemotherapy, followed by a month of RT with hormone therapy prescribed)
Example 2: A CTR completes a stage III colon chart on 12/1/20 where surgery was done at the facility, but the patient was seen by an outside medical oncology practice. The procedure at the reporting facility is to send a letter to the medical oncology practice to acquire the information. CTR codes Case Pending Additional Treatment Information = Yes; Type of Info Pending = Chemotherapy Info; Date of Expected Completion = 12/15/20 (to ensure the practice has time to review and fax it back); Abstractor Waiting on Treatment = CTR abstracting chart; Date Treatment Letter Sent = 12/1/20. Date Treatment Letter Received = (Blank). Physician Letter Sent To = Medical Oncologist Treating Patient. Additional Detail = Patient received chemo at Dr. X’s practice. Sent treatment letter 12/1. Looking for date of chemo and drugs.
Reporting:
As ONCOLog’s ad hoc reporting module allows for customizing and saving a report on any field in the database, our recommendation would be to utilize the filter and lists either in Patient Entry or in Ad Hoc Reporting to create a report that can easily used by your staff as a ‘tickler file’ for these cases.
For example:
Filter:
Accessioning Facility = Your Facility
Abstracted By = Abstractor
Case Pending Additional Information = Yes
List:
Medical Record Number
Type of Info Pending
Date of Expected Completion
Additional Detail
Considerations for Implementation:
Before implementing these fields and creating reports, review the process with your staff. If you only want to use a subset of the fields, please feel free to hide what you won’t use and customize your reports to make them most meaningful for your staff.
Set expectations for the staff. Are they running their ‘incompletes’ report weekly? Are they expected to not have any ‘old’ Date of Expected Completion dates? Is there a maximum timeframe a case can sit in ‘incomplete’? Are you flagging the State Reporting Status as ‘not ready’ until the case is completed or are you sending to the state as incomplete and re-submitting when the rest of the treatment is completed?
Consider additional fields for productivity purposes. ‘Date incomplete case opened’ and ‘date of incomplete case closed’ could be beneficial to know how long cases are staying open, how many cases have been closed per week vs. how many cases have been opened per week, etc. Revisiting cases in a concurrent abstracting setting can be very time consuming so having a way to track which cases have had additional treatment info entered can be valuable for estimating CTR time spent.
We hope this overview has been helpful in summarizing the goal of the Case Pending Additional Treatment field group. If you have any suggestions for improvement or innovative ways you’ve used the new field group, please don’t hesitate to email us at support@oncolog.com to let us know.
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