2018 Implementation of Manuals

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    Jim Hofferkamp

    I was asked to post the following on behalf of a hospital registrar…

    Due to the immense changes occurring in 2018 regarding AJCC stage, Summary stage, new data items, grade, radiation treatment, new histologies and new rules to govern assigning multiple primaries and histology, we feel it will be OVERWHELMING, even insurmountable, to implement all these changes with 2018 cases. Many of manuals have not even been released yet!! And in the cancer surveillance world, manuals are often not released by the target dates. Then it will be several more months until vendors are able to make the changes in their software! Most registries lack the staff/resources to go back & basically re-abstract all 2018 when the software upgrade is finally available. Since we do not even know what many of the data elements are yet, how are we to include all required information in text fields! In addition, I’m concerned the data is not going to be accurate; data elements will be assigned using both 2017 and 2018 requirements, and edits will not be able to validate everything.

    Then, as an accredited facility, there is the issue of RQRS concurrent abstracting and data submission. The comments on the NAACCR Forum were right on!

    I, and many fellow registrars, strongly believe that standard setters should DELAY implementation for 2018 and push back to 2019 when EVERYONE can be ready. Please consider what is being asked of the registry world. As is so aptly said on the NAACCR implementation forum, “there must be a hard line in the sand as far as time is concerned so that changes can be implemented into vendors’ software and installed for their clients PRIOR to the effective date for any change. It should no longer be acceptable to have effective dates precede implementation dates.”


    AnonymousWendy Domino

    Amen! Respectfully, we are being asked to code from manuals that do not yet exist. I’d like to ask AJCC to remove our names from their dedication page because that book does not at all represent the respect that CTRs have earned in terms of professional quality and accuracy. I agree that implementation dates must precede effective dates. We need time to study these standards we are going to be held to so our data quality and ultimately the quality of our patient’s care remains as high as possible.

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