Data Quality Cycle – QA Report 4

Extract Readiness Check

Report 4 is organized by patient and checks that all necessary clinical data is present and correct before the extract is sent to the state registry, primarily based on the identified patient type. It is sent along with Reports 1-3 in an Excel spreadsheet. There will be at least two levels of warning – e.g. record cannot be sent to the state without resolution or internal inconsistencies in data (for clinical or research purposes).

Issues Included in Report 4

  1. Duplicate TNM – one must be deleted or indicate a new tumor
  2. Tumor Checklist missing – for Dx Here Patient Types – 1, 2, 3, 4 AND Tumor Checklist should not be present – for Patient Types 5 – 10
  3. TNM Staging Form missing – form missing for Treated/Guided/Palliative here Patient Types – 1, 2, 4, 5, 6, 7, 8, 9, 10 AND TNM Staging Form should not be present – for Patient Types 3, 11, 12, 13
  4. TNM Staging Form should not be present – Patient Type – 12
  5. Date of First Treatment missing – date could not be found in infusion or treatment worksheet for Patient Types 1, 6, 8, 12
  6. Date Decided Not to Treat missing – for palliative care Patient Types – 4, 5, 9, 11
  7. Infusion Worksheet missing – for treated here Patient Types – 1, 6, 8, 12
  8. Infusion Worksheet should not be present – for non-treatment Patient Types 2, 3, 4, 5, 7, 9, 11, 13
  9. Recurrence Form Missing – for Patient Types 11, 12, 13
  10. ICD-9 Code for Active Problem marked as state-reportable not included in State of Colorado 2009 Casefinding List for Under 50 Bed Hospitals
    • Example active problems: Lung Mass, Large Cell Carcinoma Of The Lung
    • Message: < > is not a state reportable problem. Move the state reportable flag to a more appropriate active problem on the patient chart.
    • Currently not checking for this problem as it does not seem to impact the extract and it is difficult to get the change made in the EMR
  11. Original Tumor Diagnosed at Other Facility expected on Recurrence Form – for recurrence patient types 11,12, 13
  12. Treatment Date Prior to DxDate – from GenEdits error (Date of 1st Crs RX–COC (Y:2011 M:11 D:21) must be > or = Date of Diagnosis)
  13. Chemo date without a chemo drug – all patient types, a check on data in the Tumor table from the Infusion Worksheet (this was discovered in GenEdits)
  14. Histologic type difference - when the histologic type from the TNM does not agree with the pathology report Tumor Checklist
  15. Duplicate Recurrence Form – one must be deleted or indicate multiple recurrences
  16. Missing Stage Grouping in TNM – select patientid from TNMStagingLung where coalesce (TNMClinicalStageGrp, TNMpathStageGrp) is null
  17. No Laterality Indicated – no laterality listed or bilateral is listed (have the oncologist verify that this is the laterality of origin, not of disease)
  18. Original Dx Date Does Not Match Recurrence Date – Diagnosis date in tumor table should equal originial diagnosis date in recurrence if recurrence form exists
  19. TNM Staging (Notify the Oncology Group)
    • Tpath and TClinical are null in Detail
    • Mpath and MClinical are null in Detail
    • Npath and NClinical are null in Detail
    • Stage grouping calculation does not match selected values = TNM values do not compute to the Clinical Stage Grouping
    • Nodes positive is greater than nodes examined
  20. Dx Date Difference - looks for a discrepancy between the Dx Date in the path report and the TNM

This is a mock-up of this report:

Issue Date Error Identified Patient Type Last Name MRN MD Change Pt Type To: Other Resolution Send to:
9/10/2013 text from issues 1-20 above existing patient type Lastname ####### KERN