1. Automating Treatment Summary Development Using Electronic Billing Information: A Pilot Study of Survivors of Head and Neck Cancer
- Author
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Elizabeth Fortier, Ranjit Sukhu, Andrew J. Vickers, Shrujal S. Baxi, Kevin C. Oeffinger, Talya Salz, Mary S. McCabe, Andrew L. Salner, and Stacie Corcoran
- Subjects
Adult ,Male ,medicine.medical_specialty ,media_common.quotation_subject ,MEDLINE ,Pilot Projects ,03 medical and health sciences ,0302 clinical medicine ,Cancer Survivors ,Medicine ,Electronic Health Records ,Humans ,Medical physics ,Quality (business) ,030212 general & internal medicine ,Registries ,media_common ,Aged ,Neoplasm Staging ,Aged, 80 and over ,Oncology (nursing) ,business.industry ,Extramural ,Health Policy ,Head and neck cancer ,Middle Aged ,medicine.disease ,Oncology ,Head and Neck Neoplasms ,030220 oncology & carcinogenesis ,Quality in Action ,Neoplasm staging ,Female ,Electronic billing ,business ,Algorithms - Abstract
PURPOSE: Although the provision of a treatment summary (TS) is a quality indicator in oncology, routine delivery of TSs remains challenging. Automatic TS generation could facilitate use, but data on accuracy are lacking in complex cancers such as head and neck cancer (HNC). We developed and evaluated an electronic platform to automate TS generation for HNC. METHODS: The algorithms autopopulated TSs using data from billing records and an institutional cancer registry. A nurse practitioner used the medical record to verify the accuracy of the information and made corrections electronically. Inaccurate and missing data were considered errors. We described and investigated reasons for errors in the automatically generated TSs. RESULTS: We enrolled a heterogeneous population of 43 survivors of HNC. Using billing data, the information on primary site, lymph node status, radiation, and chemotherapy use was accurate in 93%, 95%, 93%, and 95% of patients, respectively. Billing data captured surgery accurately in 77% of patients; once an omitted billing code was identified, accuracy increased to 98%. Chemotherapies were captured in 90% of patients. Using the cancer registry, month and year of diagnosis were accurate in 91% of cases; stage was accurate in 28% of cases. Reprogramming the algorithm to ascertain clinical stage when pathologic stage was unavailable resulted in 100% accuracy. The algorithms inconsistently identified radiation receipt and treating physicians from billing data. CONCLUSION: It is feasible to automatically and accurately generate most components of TSs for HNC using billing and cancer registry data, although clinical review is necessary in some cases.
- Published
- 2018