54 CREATION OF A NEAR REAL-TIME BLADDER CANCER PATIENT TRACKING AND REPORTING TOOL IN THE VETERNS AFFAIRS HEALTHCARE SYSTEM

Abstract

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Evidence-Based Medicine & Outcomes (I)1 Apr 201354 CREATION OF A NEAR REAL-TIME BLADDER CANCER PATIENT TRACKING AND REPORTING TOOL IN THE VETERNS AFFAIRS HEALTHCARE SYSTEM Jeremy Shelton, Caroline Goldzweig, Stanley Ho, Carol Bennett, Stephanie Chu, Alan Kaplan, and Saigal Christopher Jeremy SheltonJeremy Shelton Los Angeles, CA More articles by this author , Caroline GoldzweigCaroline Goldzweig Los Angeles, CA More articles by this author , Stanley HoStanley Ho Los Angeles, CA More articles by this author , Carol BennettCarol Bennett Los Angeles, CA More articles by this author , Stephanie ChuStephanie Chu Los Angeles, CA More articles by this author , Alan KaplanAlan Kaplan Los Angeles, CA More articles by this author , and Saigal ChristopherSaigal Christopher Los Angeles, CA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.1430AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The care of non-muscle invasive urothelial bladder cancer is effective at preventing disease recurrence and disease progression, but it is intensive and multiple studies have identified poor overall compliance with recommended therapies. We sought to leverage existing information technology resources at the Veterans Health Administration (VHA) Greater Los Angeles Medical Center (GLA VAMC) to develop a tool to identify and track all patients followed by the Division of Urology with bladder cancer in near real-time as an aid to ensuring receipt of timely and guideline recommended care through a population based disease management approach. We describe the creation and validation of this tool. METHODS To identify patients with bladder cancer we used an iterative process to develop an algorithm using a combination of administrative and clinical data elements including, International Classification of Diseases Ninth Revision (ICD-9) and Current Procedural Terminology (CPT) codes, VHA facility and clinic codes, and VHA death and facility attribution tables. We validated this list by 1) comparing it to a list of patients generated by the pathology department and defined by Systematized Nomenclature of Medicine (SNOMED) morphology and topography codes for bladder malignancy, and 2) comparing it to patients identified by the VA Comprehensive Cancer Registry (VACCR). To identify delivery of recommended urologic care we developed algorithms defined by ICD-9 and CPT codes, and where data was unreliable or missing, we used existing informatics tools to generate the necessary clinical data points. RESULTS Using our algorithm we identified 471 patients with bladder cancer followed by the Division of Urology at the Greater Los Angeles VA between 1/1/2006 and 4/30/2012. 219 patients were identified by SNOMED codes as having a primary diagnosis of bladder cancer during this same period. All 219 of these patients were also identified by our algorithm. During the same time period the VACCR identified 236 patients with primary urothelial bladder carcinoma, all of who were again identified by our algorithm. After excluding patients who were deceased or who moved away, we identified 361 active bladder cancer patients, which included all active and alive patients detected by SNOMED codes and the VACCR. CONCLUSIONS We created an infomratics tool in the VA that successful identifies all patients with bladder cancer in near real-time. Further work is needed to validate the detection of bladder cancer treatments and surveillance. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e22 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jeremy Shelton Los Angeles, CA More articles by this author Caroline Goldzweig Los Angeles, CA More articles by this author Stanley Ho Los Angeles, CA More articles by this author Carol Bennett Los Angeles, CA More articles by this author Stephanie Chu Los Angeles, CA More articles by this author Alan Kaplan Los Angeles, CA More articles by this author Saigal Christopher Los Angeles, CA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...