Purpose

The purpose of the South Island Clinical Cancer Information System (SICCIS) is to provide clinicians, planners and funders of cancer services, and cancer research with quality clinical data and enable monitoring of cancer instances, treatment outcomes, and nationally agreed key performance indicators across the South Island.

The SICCIS facilitates improvements in patient outcomes through contribution to estimates of need on which investment decisions can be based, including workforce development, purchase of capital items, and organisation of service delivery, and thereby enhances the efficiency and effectiveness of the system in relation to the patient’s journey. In addition the database within the SICCIS will streamline case identification for participation in clinical trials.

An underlying core principle of this project is to link and align with related national work streams and leverage off existing systems. The project will provide shared learning with the North Island Cancer Centres with the potential for them to link to SICCIS in the future. Implementation of the SICCIS will also serve to foster clinical collaboration across the South Island Cancer centres, both public and private.

Rationale

The rationale for the project is that in New Zealand the collection of quality clinical data is a long-standing issue. The National Health IT Board recognises that "The NZ health ICT sector is characterised by a large number of individual systems dispersed amongst DHBs, central government agencies, primary care, private hospitals, rest homes and a large number of non-government organisations (NGOs) [...] and when attempts are made to view the information about a patient as a whole, it is quickly apparent that the information is so fragmented and inconsistent that […] it becomes an impossible task" (National Health IT Plan; National Health IT Board; 09/2010).

Core cancer data definitions are a priority work stream for the National Cancer and Palliative Care Information System Advisory Group but this is a complex project that will take time to eventuate. There remains an urgent need to access quality clinical data to assist in the evaluation of systems performance and to monitor and improve outcomes for patients. Clinicians and Cancer Researchers have long identified a need for a cancer database with clinical treatment details.

Since February 2010 all three South island cancer centres utilise the software MOSAIQ® (ELEKTA, USA) in Radiation and/or Medical Oncology for patient scheduling, treatment, and follow-up. MOSAIQ stores patient demographic, diagnosis, and treatment information. An opportunity exists to leverage on the existing oncology system MOSAIQ and base the South Island cancer registry/database on the oncology registry system METRIQ® (ELEKTA, USA), which accepts data imports from multiple MOSAIQ instances via MOSAIQ CONNECT® (ELEKTA, USA).

The Southern Cancer Network Steering Group is supportive of both this proposal and the use of SCN accrual to fund the purchase and customisation of the METRIQ MOSAIQ and MOSAIQ CONNECT software to facilitate the establishment of the SICCIS.

Linking the three MOSAIQ instances into METRIQ would enhance the existing systems and functionally create a stand-alone South Island Clinical Cancer Information System (SICCIS). Importantly, the SICCIS would incorporate patient data from both the private and public health sector. Furthermore, North Island cancer centres could also be linked in.

This project links in with five of the nine workstreams of the National Health IT Plan: Workstream 2 – Continuum of Care, Workstream 4 – Clinical Support, Workstream 6 – Population Health, Workstream 7 – Business Support, and Workstream 8 – Safe Sharing Foundations.

According to the South Island Regional Information Systems Plan (South Island Region Information Systems Plan 2010 – 2015, Version: Draft v0.1; 07/2010), there is a low level of alignment of South Island Information Systems with the National Health IT Plan at present. The SICCIS represents a regional implementation of a strategic IT project that provides clear leadership to help bridge that gap in line with the National Cancer Strategy and Action plan, and with the South Island Regional Information System. The SICCIS is one of a number of SCN activities which are related to the capture and monitoring of national and regional cancer priorities, measures and indicators, and falls within the strategic directions for system quality and system improvement according to the Southern Cancer Network South Island Strategic Plan 2009-2014 (Southern Cancer Network South Island Strategic Plan 2009-2010; 11/2009). The SCN is working with key persons regional, national, and international to ensure capacity for accurate data for cancer within the SICCIS.

Process

There are two main aspects to this project:

1. The software that will be used as the basis for the SICCIS
2. The data that is to be collected

Consequently the implementation of the SICCIS draws on the expertise from various disciplines and/or institutions: Ministry of Health, Cancer Clinicians, Information Technology, Researchers.