Electronic capture and communication of synoptic cancer data elements from pathology reports: results of the Reporting Pathology Protocols 2 (RPP2) project.

Pathology reports represent a rich data source for cancer registries. The College of American Pathologists (CAP) Cancer Checklists present pathology reports in synoptic form and allow registries to be updated electronically. To assess the challenge of employing the CAP Cancer Checklists in pathology laboratories and transmitting that information to cancer registries, we conducted a pilot project: the Reporting Pathology Protocols project (RPP2). The RPP2 project was a multi-year, "proof of concept" demonstration that assessed pathology report-generated data for 3 CAP Cancer Checklists (breast, prostate, and melanoma) in several different cancer registry-pathology laboratory combinations in 3 states. Collaborating pathology laboratories and state cancer registries in California, Maine, and Pennsylvania identified key questions (queries) to address in the course of the project, developed and tested standardized HL7 messaging specifications to link senders and recipients, and then assessed the actual process results using either parallel reporting or retrospective-prospective cases for each tumor type. Successful electronic transfer and capture of pertinent data elements for numerous examples of each tumor type was accomplished in each participating cancer registry/reporting laboratory/information system combination. We noted shortcomings in the electronically encoded CAP Checklists as opposed to text-based reports, particularly for breast cancers. We uncovered opportunities to improve Checklists and the information systems that incorporate them. Workflow, productivity, and timeliness of reporting are areas where electronically encoded reports may enhance cancer registry processes. The accuracy and completeness of electronically encoded data appears largely comparable to text-based data, but subject to the degree of synchrony between the formats of text-based and electronic reports.