Context: Understandings (Facts, Assumptions, and Obstacles)
Facts are accepted truths that are so important to understanding the effort that not knowing them would lead to confusion or false results (not elsewhere specified).
| No. |
Facts |
| 1 |
NCI cannot pay for the development and maintenance of 13 independent systems |
| 2 |
Committed registry participation is essential to the success of the project |
| 3 |
Some existing systems will need to be replaced "before too long" |
| 4 |
Funding exists for this project |
| 5 |
NCI has been gradually getting into this area for some time, via SEER*Stat, SEER edits, and NAACCR metafile, etc. |
| 6 |
All registries have their own unique needs. For example: a hospital or a regional registry may need help or coordination from a central registry. |
| 7 |
Some registries are already in the process of replacing their systems or have recently replaced all or part of their systems |
| 8 |
CDC and CCR are currently working on a similar effort |
| 9 |
Limited experienced personnel both for this project and to run basic operations |
| 10 |
This is big and this is hard - a complex project |
| 11 |
Some registries do not have the IT staff to independently redevelop their system. |
| 12 |
A new system will provide core functionality but will require some registry adjustments to take advantage of the new system |
Assumptions are items that cannot be proven or demonstrated to be true at this time, but are accepted as true until confirmed or denied.
| No. |
Assumptions |
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| 1 |
Past experience with the California/Connecticut project has shown that this type of project will be difficult. However, methodology and technological advances since then allow us to assume that this project can be accomplished. |
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| 2 |
Every registry has had to undergo change and has had the opportunity to think about what they would like to see in a new system |
|
| 3 |
Some registry activities will not be affected by a new system, but will need to be coordinated with it. |
|
| 4 |
The core systems have to be designed by getting into the computer system details |
|
| 5 |
Local (non-core) manual procedures don't need to be studied in extreme detail |
|
| 6 |
The project will be continuous and long-term |
|
| 7 |
Data migration will be a huge undertaking for the registries |
|
| 8 |
We all have inefficiencies in our processes, for whatever reason, that can be improved |
|
| 9 |
NCI's biomedical computing contractor will be involved throughout the process. This allows for the continuous support of enhancement and maintenance of a central core system. |
|
| 10 |
Laws (federal and state) that affect data privacy could impact any solution. The more restrictive of federal and state laws will be the ones the solution needs to accommodate. However, we believe neither will likely impact the operations of Central Cancer Registries (CCRs) with regards to reportable diseases.
- Under HIPAA (Health Insurance Portability and Accountability Act - 1996), CCRs are not covered in terms of how they share data to/from facilities.
- State laws could be a problem, but because most CCRs are also state registries and because they already do a good job protecting patient data, their state legislatures are unlikely to pass legislation that is stricter than HIPAA.
Therefore, for this solution, we are going to assume that privacy laws will not restrict how reportable disease data is shared back to facilities (although the Registries may choose to restrict this). However, it appears that special study disease data will fall under HIPAA, so this is a consideration. |
Dennis Deapen
via Nicki
June 19, 2002 |
Obstacles are barriers to success. They are unlike constraints in that it is not accepted that we must live with them. We will attempt to work around or remove them.
| No. |
Obstacles |
| 1 |
A registry may perceive its computer system as better than what this project could possibly design |
| 2 |
Atlanta must buy Dell hardware and a specific network product |
| 3 |
Resistance to change in the local registries |
| 4 |
In learning curve your production goes down |
| 5 |
Object orientation requires a shift in your thinking |
| 6 |
There are differing data storage requirements at the data item level |
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Surveillance Research Program
Division of Cancer Control &
