Two of the country's eight regionally focused cancer registries began a pilot program in November that uses integration tools from InterSystems Corp. in Cambridge, Mass., to integrate, validate and manage information from hundreds of data sources for a rules-based system called Entente. The NHS Cancer Registry will use Entente to assess the outcomes of cancer treatments, study the impact of environmental and social factors on cancer risk, and evaluate cancer prevention and screening programs.
The Merseyside & Cheshire Cancer Registry and the Thames Cancer Registry will be evaluating InterSystems' Ensemble tools for the next three months, said Chris Carrigan, national coordinator for cancer registration. Ensemble includes an integration server, application server, object database and a unified development and management environment -- all combined in a single product for integrating applications.
The tools will be used to take data feeds from multiple sources and link them automatically to the regional registries and the NHS centralized registry, replacing much of the work now done manually to update registries, Carrigan said.
'The number of sources of data from which we would need to make a registration could be hundreds,' he said. 'It is virtually impossible to do high-quality, high-volume cancer registration by hand.'
Replacing many of the manual processes will help keep the registries more up to date, Carrigan said. There is currently an 18-month lag between the time a patient's cancer treatments begin and information about it is available in the registry, he said.
'Every data record that comes in electronically to the [regional] data registry ... will be automatically linked to NHS to check and authenticate who the person is and to augment other data in the registry,' Carrigan said. 'It improves the registration process.'
The system also will allow health officials to apply standardized business rules about how the data is categorized. Now, as data comes in, people decide how different parts of it will be categorized. Because that process is based on human decision-making, there can be discrepancies in how data is categorized and analyzed.
'I can never tell whether it is a right or wrong decision because it is in someone's head,' Carrigan said. 'With the [new] system, I can control and visualize the business rules that are happening within the registries.'
The system will also allow the registries to more easily accept the influx of data expected as the country continues to roll out the NHS National Program for IT, which calls for a single electronic record of care for all citizens. With that program, the amount of data received by registries could increase by 100 percent over the next several years, he said.
'As new information feeds are made available ..., we'll be able to hook into those, utilize them and build them into the process much more effectively.'