Eureka High Level Process Flow: Input/Output

1

Patient

AdmissionAdmission

TumorTumorDC Passive Follow-up

DeletionActive

Follow-up

PathologyReport

MergedPatient

MergedTumor

AdmissionAdmission

Correction

Geocoding

DMV Passive Follow-up

Eureka Data Model: A Sample Patient Set and its Data Sources

New CaseReport/Abstract




Pathology Lab

Geocoding Vendor

Bureau ofVital Records

Dept. ofMotor Vehicles

2

New Case

ActiveFollowup

PassiveFollowup/

DC

Correction

GeoCoding

Deletion

CaseFinding

Input Documents

NewCase?

Upload/Validate

VisualEdit / QC

LinkageResolution

Link /Match

ReviewRequired?

Apply /Consolidate

Eureka High Level Process Flow: Input5/14/2003

ManualReview/

ConsolidationResolution

NER Data

Yes

No No

Yes

ReviewRequired?

No

Yes

DocumentProcessingComplete

Shared Follow UpResearch DataProduction ReportsQuality ReportsRegional Data SystemsHospital Data Systems

Eureka High Level Process Flow:

Input/Output

3

SourceDocument

Eureka Data Flow Diagram 1: New Case Abstract is Uploaded4/26/2004 BW

IPAQ(PotentialDuplicate)

Audit Log(AdmissionCreated)

TransmittedPackage Log

Transmission Log

NewCase

EurekaTransmit

Folder

EurekaDatabase

Update

Upload

IPAQ (RejectResolution)

AdmissionMaster

Create

Reject

NewCaseDocument

Accept

AdmissionDetail

Adm RegXref

Reject Bin

Create

AdmissionNames 1 - 4

IPAQ(VisualEditing)

2.5Assign

Document forInteractiveProcessing

Automatically

2.6.1DetermineAdmission

Responsibility

6Perform

AutomaticEdits

2.1.1Process a New CaseAbstract

2.1Validate

Package &Load Data

1.1TransmitPackage

5Link

Document(Dup Check)

Create

ErrorMessages

Error Log

AdmissionAudit Log

Detail (dataconversionchanges)

Create

Create

Create

Not a duplicate

duplicate

Create

Create

Create

Create

Create

If Edit Errors,then create

Update

Update

Create

SourceDocument

NewCaseDocument

Create

Create

CreateStop

Create

4

Eureka Data Flow Diagram 2: Admission is Visually Edited4/26/2004 BW

IPAQrecord(VisualEditing)

Eureka Database

Regional Visual Editor

AdmissionVE IPAQ Selected

IPAQ(Linkage

Resolution)

2.3.1PerformVisualEditing

2.3Perform

InteractiveProcessing

7.6Standardize

Addressat DXCity

7.5Standardize

Addressat DXStreet

7.1PrepareAddress

forGeocoding

6Perform

Automatic Edits

Audit Log(VisualEditing)

AdmissionMaster

AdmissionDetail

AdmissionNames 1 - 4 Admission

Audit LogDetail (VEchanges,status)

Adm RegXref

ActorchoosesFinishandLink

VEDiscrepancy

Log (VEchanges)

AdmissionComments

10.3ViewCase

History

2.3.2.1Resolve

NewCase

Linkage

Update (VE changes and status)

Update (VE changes)

Update

Update

Edit ErrorsFound

Create, Delete, or Update

Create, delete, or Update

Create

CreateCreate

Update statusSource

Document

Clear IPAQ

CreateNoEdit

Errors

5

Eureka Data Flow Diagram 3a: Linkage Resolution - New Patient, New Tumor4/26/2004 BW

IPAQ(Linkage

Resolution)

Eureka Database


AdmissionLinkage Resolution

IPAQ Selected

IPAQ(Consolidation)

2.3.2.1Resolve NewCase Lnkage

2.3Perform


5Link

Document

7.1PrepareAddress

forGeocoding

Audit Log(Linkage

Resolution)

Admission(master)

AdmissionDetail

AdmissionNames 1 - 4 Admission

Audit LogDetail

(Patien ID,Tumor ID,

Status

Adm RegXref

Update

2.3.3Resolve

Consolidation

Create

PatientNames 1 - 4

Pat RegXref

Tumor

Tum RegXref

2.8.1.1 -ConsolidateSequenceNumber -Central

Update

Create

Patient

Visual editor choosesto create a new

patient and tumor

Tumor AuditLog Detail(Seq_No_Central)

Audit Log(Tumor

Created)

Audit Log(PatientCreated)

Create Create

Clear IPAQ

Create

consolidation not necessary

Create

Create

consolidationnecessary

Create

Update admission (Patient ID, Tumor ID, Status)

TransmittedPackage Log

SourceDocument

Update Status

Case Complete

Return to IPAQ Detail/Summary/Next IPAQ task

Update package status

Continuedfrom Visual

Editing

6

Eureka Data Flow Diagram 3b: Linkage Resolution - Exising Patient, New Tumor4/26/2004 BW

IPAQ(Linkage

Resolution)

Eureka Database



IPAQ Selected


2.3Perform


7.1PrepareAddress

forGeocoding

Audit Log(Linkage

Resolution)

Admission(master)

AdmissionDetail


PatientAudit Log

Detail(Central_Tum

_No_Last)

Adm RegXref

Update

2.3.3Resolve

Consolidation

Tumor

Tum RegXref

2.8.1.1 -ConsolidateSequenceNumber -Central

Update

Update(Central_Tum_

No_Last)

Patient

Tumor AuditLog Detail(Seq_No_Central)

Audit Log(Tumor

Created)

Create

Create

CreateCreate

CreateAdmissionAudit Log

Detail(Patien ID,Tumor ID,

Status

Create

5Link

Document

Visual editor chooses to create a new tumor for an existing patient

Clear IPAQ

Update admission

IPAQ(Consolidation)

Create

SourceDocument Update Status


Editing


7

Eureka Data Flow Diagram 3c: Linkage Resolution - Exising Patient and Existing Tumor4/26/2004 BW

IPAQ(Linkage

Resolution)

Eureka Database



IPAQ Selected

IPAQ(Consolidation)


2.3Perform


Audit Log(Linkage

Resolution)

Admission(master)

AdmissionDetail


Adm RegXref

2.3.3Resolve

Consolidation

Create

TumorPatientCreate

AdmissionAudit Log

Detail(Patien ID,Tumor ID,

Status

Create

5Link

Document

Clear IPAQ

Update admission (Patient ID, Tumor ID, Status)


Visual editor chooses to link admission

to an existing patient and tumor


Editing

SourceDocument Update status

8

Eureka Data Flow Diagram 4: New Case Consolidation4/26/2004 BW

IPAQ(Consolidation)

Eureka Database

Regional VisualEditor

AdmissionConsolidationIPAQ Selected

2.3.3Resolve

Consolidation

2.3Perform


Audit Log(Consolidation)

Admission(master)

AdmissionDetail


Adm RegXref

Tumor

Clear IPAQ

Patient AuditLog Detail

(Consolidationchanges, Not

Ready ForResearch Flag)

2.8.1ConsolidateCase Data

2.11Edit a

Patient Set

7.1Prepare

DiagnosisAddress forGeocoding

7.6StandardizeAddress atDiagnosis -

City7.5

StandardizeAddress atDiagnosis -

StreetIf Address at DX changed

Visual editor resolves conflicts, finalizes patient/tumor data, and selects Finish Consolidation

Admission Audit Log Detail

(Status, NotReady For

Research Flag)

Tumor AuditLog Detail

(Consolidationchanges,

Not Ready ForResearch Flag)

CreateCreate

Update admission (Not Ready for Research, Status)

SourceDocument

TransmittedPackage Log Update rollback eligibility, package status

Update Status

Update (Consolidation changes,Not ReadyFor Research Flag)

Return to IPAQ Detail/Summary/Next IPAQ task

Case CompleteNo

EditErrors

Create

Create

If followupdata changed,

then create

Data SharingHold Queue

(SharedFollowup)

Continuedfrom Linkage

Resolution

SaveDatabase changes

Patient

9

Correction SetLinkage / and

Incompete IPAQtask test

Eureka Corrections Upload Process 8/29/2005cor. file

Perform anynecessary data

conversions

DetermineAdmission

Responsibility

Createcorrection

set

Associatenew

correctionwith existing

set

Match found andexisting

"Pending","Linkage Resolution",

or "Manual ReviewIPAQ task

exists

Eureka Upload(file validation,

etc)

Is correctionset linked to an

admission?

No match found or match found

with no"Pending",

"Linkage Resolution",or "Manual Review"

IPAQ task

AdmissionLinkage

(correction setto admission)

Associate allthe correctionsin the set withthe matchedadmission

Associate thecorrection

set with thematched

admission

Check to see if special review

required(CS conversion,

etc)

no review required

enter oneor moreReviewTable

records

No

matchfound

End

Yes

Yesupdate correctionto include status

of "Deleted" End

yesClear

incompleteIPAQ

Update allcorrections in the

set to have astatus of"Deleted"

End

Process eachcorrection

AdmissionLinkage

(correction setto admission)

Associate thecorrection

set with thematched

admission

Create"Pending"IPAQ task

Associate allthe correctionsin the set withthe matchedadmission

Updatecorrection toinclude same

status as IPAQ

Match found

no matchfound

check to see if admission is

marked asdeleted

No

check to see if admission is

marked asdeleted

Updatecorrection toinclude same

status as IPAQ

No

No matchfound

review required

10

End

Is ManualReview

Required?

Automaticallyupdate the

linkedadmission

No

Is theadmissionlinked to a

patient/tumor?

No

Yes

Updatecorrectionsapplied to

have"Complete"

Status

Updatecorrections

to have"Complete"

Status

AdmissionLinkage

(correction set toadmission)

Eureka Corrections Interactive Processing 9/3/2005

Associatecorrection set

withadmission

PerformInteractiveProcessing

(IPAQ)

No definitematch

Select a "Pending" or"Linkage

Resolution"correction set

IPAQ task

Yes

Manualsearch

End

Deletecorrection set

Manual Review

User selects a matching admission

ResolveConsolidation

YesIs the

admissionlinked to a

patient/tumor?

No End

Updatecorrections to

have "Complete"Status


Yes

Consol.data itemschanged?

Yes

No

Send tocase

finding

No

Updatecorrections tohave "Deleted"

Status

ChangesApplied?

Select a "Manual Review" correction set IPAQ task

Select a "Consolidation" correction set IPAQ task

End

Hasadmission

been visuallyedited?

Yes

No End


Yes No

ResolveCorrection Set

Linkage

Correctionvalues all thesame as theadmission

values?

No

definitematch

Yes

11

AdmissionLinkage

(active follow-upto admission)

Eureka Active Follow-up Upload Process 9/2/2005

activefollow-up


conversions

DetermineAdmission

Responsibility

Create "Linkage Resolution" IPAQ task

Associateactive

follow-upwith

admission

Singlematchingadmission

found


etc)

No match foundor only possible matches found

Write DataSharing Hold

Queue (DSHQ)records for all

reportingfacilities who

wish to receiveshared follow-

up

End

Process eachactive follow-up record

Update active follow-up to have"Linkage Resolution" Status too

check to see if admissionis marked as

deleted

No

Performactive

follow-upapply rulesin memory

PerformAdmission

Edits Set andcompare with

baseline to seeif we would

have new editerrors

PerformAdmissionEdits Set

as abaseline

Is ManualReview

Required?(Conflicts orpotential edit

errors)


linkedadmission

No


patient/tumor?

Performactive follow-

upconsolidation

rules inmemory

PerformPatient andTumor editsets and

compare withbaseline tosee if we

would havenew edit

errors

PerformPatient

andTumor

Edit Setsas a

baseline

Is ManualConsolidation


errors)


linked patientand tumor

Didconsolidationrules yield any

updates toapply?

End

Update active follow-up to have"Deleted" Status

End

Did applyrules yield

any updatesto apply?

Yes

No

Yes

Create "ManualReview" IPAQ task

Update active follow-up to have"Manual Review" Status too

End

No

End

No Yes

No

Create"Consolidation"

IPAQ task

Update active follow-up to have"Consolidation" Status too

EndYes

Yes

Yes


End

Update activefollow-up to have

"Complete" Status

Update active follow-up tohave "Complete" Status

12





up

End

Performactive

follow-upapply rulesin memory

PerformAdmission

Edits Set andcompare with

baseline to seeif we would

have new editerrors

PerformAdmissionEdits Set

as abaseline

Is ManualReview


errors)


linkedadmission

No


patient/tumor?

Performactive follow-

upconsolidation

rules inmemory



would havenew edit

errors

PerformPatient

andTumor

Edit Setsas a

baseline



errors)


linked patientand tumor


updates toapply?

Did applyrules yield

any updatesto apply?

Yes

No

No

No Yes

Yes

Yes

Updateactive

follow-up tohave

"Complete"Status

Update activefollow-up to have

"Complete" Status

AdmissionLinkage

(active follow-upto admission)

Eureka Active Follow-up Interactive Processing 9/3/2005

Associateactive follow-

up withadmission

Definite match


(IPAQ)

No definitematch

Select a "LinkageResolution"

active follow-up IPAQ task

Yes

Manualsearch

End

Delete activefollow-up

Manual Review

User selects a matching admission


YesIs the

admissionlinked to a

patient/tumor?

No EndUpdate active

follow-up to have"Complete" Status


Yes


Yes

No

Send tocase

finding

No

Update activefollow-up to have"Deleted" Status

ChangesApplied?

No

Select a "Manual Review" active follow-up IPAQ task

Select a "Consolidation" active follow-up IPAQ task

End


ResolveActive Follow-

up Linkage

13

Eureka Passive Follow-up Upload Process 9/4/2005

passivefollow-up


etc)

Process eachpassive follow-up record

Is this a DC orNDI passivefollow-up?

Yes


conversions

PatientLinkage (Link

passivefollow-up to

Patient

No

Associate passivefollow-up with patient

single positive match

Has linkedpatient been

deleted?

No





up

End

Performpassive

follow-upconsolidation

rules inmemory

PerformPatient andTumor edit

sets andcompare with

baseline tosee if we

would havenew edit

errors

PerformPatient

andTumor

Edit Setsas a

baseline



errors)


linked patient


updates toapply?

No Yes

No

Create"Consolidation"

IPAQ task

Update passive follow-up to have"Consolidation" Status too

EndYes

Update passive follow-upto have "Complete" Status

one or more possible matches foundCreate "Linkage

Resolution" IPAQ taskEnd

Update passive follow-up to have"Linkage Resolution" Status

no match for a DC

statmasterpassive

follow-up

Createcase finding set

Mention ofcancer?

YesCreate "Follow-backReady" CFAQ task

Update passive follow-up to have "Follow-back

Ready" StatusEnd

Update passive follow-up tohave "Deleted" Status

End

No

no match for a non-DCstatmaster passive follow-up

Yes

Determine PatientResponsibility

14

Patient Linkage (passive follow-

up to patient)

Eureka Passive Follow-up Interactive Processing 9/4/2005

Associatepassive

follow-up withpatient

Definite match


(IPAQ)

No definitematch

Select a "LinkageResolution"

passive follow-up IPAQ task

Manualsearch

End

Delete passivefollow-up

User selects a matching patient

EndUpdate passive

follow-up to have"Complete" Status


Send tocase

finding

Update passivefollow-up to have"Deleted" Status

Select a "Consolidation" passive follow-up IPAQ task

View deathcertificate

ResolvePassive

Follow-upLinkage





up

End

Performpassive

follow-upconsolidation

rules inmemory



would havenew edit

errors

PerformPatient

andTumor

Edit Setsas a

baseline



errors)


linked patient


updates toapply?

No Yes

Yes

Update passive follow-upto have "Complete" Status

No End

Changesapplied?

Yes

EndUpdate passive

follow-up to have"Deleted" Status

No

15

Eureka Geocoding Upload Process 9/30/2005

geocoding file

from GDT Eureka Upload(file validation,

etc)

Process each geocoding record

Retrievetumor byTumor ID

Reject geocodingrecord

EndNot

found

tumor found

Is tumormarkeddeleted?

YesUpdate geocoding record's

status to "Deleted"End

No

Associategeocoding

record with thetumor and itsrelated patient

Checkreturned

certainty codeand census

tract code forblank

notblank

blank

Change census tract 00 to999997 or 999998 and census

certainty to 9 if necessary

Do addr dx street,city, and zip

1-5 sent to GDTmatch the current

tumor values?

Yes

NoUpdate geocoding record's

status to "Deleted"End

Convertreturned

GDTCFIPScounty codeto our CCR

county code

Doesreturned and

converted countycode match thetumor's county

code?

Yes

No

Create "Consolidation"IPAQ task

Update geocoding record'sstatus to "Consolidation"

End

Convertcensus

tract code

Applycensus

values totumor inmemory

Value(s)changed?

No

Value(s)changed?

Updatetumor

Geocodingrelated edit

errors?

Yes

No

Updatetumor

Yes

No

Yes

End

Updategeocoding

record's statusto "Complete"

16

Case Finding Flow

17

Followback

Stat MasterFollowup File - Positive Match - Possible Match

Upload toEureka

LinkageAuto Apply to

Consolidated DataPositive MatchNo Linkage ConflictNo Consolidation Conflicts

UnassignedCFAQ

Process DCRecord

DC Lookup &Storage

ManuallyEnter Data

from Image

CreateFollowbackPackage

View DC Image

LinkageResolution

Possible Match Apply toConsolidated Data

MatchMade

ConflictResolution

Conflict

No Match

Consolidation NoConflict

Stat MasterFollowup File- Non-match w/Cancer

Upload toEureka

Group intoCF Setwhen applicable

FirstLinkage

AssignedCFAQ

Reportable

ReportableFinal

Linkage

Pull DC Image forFollowback Package

Electronic: Process New Case Normally in Eureka

Postal Mail: Assign Disposition in Case FindingRemove from CFAQ

Followback Package Mailed or Delivered to Reporting Source

Assign Disposition in Case FindingRemove from CFAQ

NoYes Delete Record

Time

Case FindingNo

18

Flow of Electronic Pathology Reports

from TransMed Software

Transmedreceives reports(HL7 messages)

Reportsuploaded to

Eureka

Reports assigned to a user (PPAQ)

User selects areport

UserClassifies tumor

Assigns a physician

Eurekaperformslinkage

Report sent toConsolidation

Report sent toCasefinding

User determinesreportability

User discardsreport

Yes No

Notreportable

Reportable