Background: Electronic medical records may potentially be used to instantaneously monitor medical care. Poor survival and the increasing incidence of cancer among American Indians (AI) have focused attention on use of Indian Health Service (IHS) records to track screening. Primary Objective: Determine the validity of IHS electronic databases for tracking preventive services. Methods: AI with a malignancy diagnosed in 1995 were identified through the New Mexico Tumor Registry (NMTR), a participant in the National Cancer Institute's (NCI) Surveillance, Epidemiology and End Results (SEER) Program. Electronic laboratory and Patient Care Component (PCC) records from the IHS Records and Patient Management System (RPMS), were collected from 5 IHS hospitals participating in the IHS/NCI Patterns of Cancer Care Project. Charted preventive services were abstracted for 172 cases. All chart information on mammography, whether performed by IHS or a contractor, were collected. Results: The following were missing from electronic records: 18% (10/57) of paps, 83% (24/29) of mammographies, 58% (15/26) of clinical breast exams, 100% (17/17) of digital rectal exams, 51% (19/37) of PSA tests, 100% (2/2) of fecal occult blood tests, 80% (4/5) of colonoscopies, 41% (131/317) of blood glucose tests, 62% (13/21) of Hemoglobin A1C (glycosylated hemoglobin) tests, 25% (52/207) of total blood cholesterol tests, 74% (17/23) of adult vaccinations, 33% (3/9) of PPD tests, 43% (18/42) of Chlamydia cultures. Conclusions: PCC and lab components of RPMS underestimate preventive services. Increasing incidence of cancer and other chronic conditions among AI, such as diabetes, necessitate well-documented progress in delivery of preventive services.
Learning Objectives: 1. Identify major sources and types of data to track cancer screening among AI. 2. Recognize major problems with missing information and where improvements have been made
Keywords: Cancer Screening, Data/Surveillance
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.