We are pleased to report that the Legislature has passed and the Governor signed AB 2325 by Assemblywoman Bonilla. AB 2325 would require that on or after January 1, 2019 that all pathologists diagnosing cancer will report those cancer diagnoses via electronic means to the California Cancer Registry (CCR). The bill resulted from a dialogue with the author who had an interest in clinical trials for cancer patients and the possible use of California Cancer Registry data to advance the goals of cancer treatment and outcomes.
In early 2015 representatives of the CSP began a dialogue with the CCR over the need for changes for cancer reporting. From those discussions came the creation of the California Data Modernization Consortium (CDMC), and our hopes for reforming the current reporting method to CCR. The CDMC includes representatives from the CSP, CAP, major EHR vendors, and the large health care systems. It was decided that though other details of the possible changes to the CCR would come from the deliberations of the CDMC that it was already clear that three things needed to change; (1) initial reporting of cancer diagnoses should come from the pathologist, (2) that reporting should be done in a standardized format, and (3) the report should be submitted electronically. There have been several pilots at select California hospitals using the CAP eCancer checklist and electronic reporting to CCR.
After introduction, AB 2325 was amended several times as it moved through the legislative process. The reporting will be required to use the College of American Pathologists cancer protocols data elements but the pathologist can submit in any electronic means directly from the Electronic Medical Record, or through a web portal provided by California Department of Public Health (CDPH). CDPH will prescribe the data to be submitted and will work with stakeholders to designate a standardized format for submission.
There were amendments to not penalize or make the pathologist responsible for missing or inaccessible patient demographic information that exceeded the required cancer-specific data elements. CDMC and its workgroups will be developing the specific patient identifier elements that should be provided in the reports.
AB 2325 was also amended to specifically indicate that a pathologist is not required to submit the same report more than once. In essence if a specific report is submitted electronically that CDPH can't require the same pathology report via a different means.
AB 2325 establishes the basic foundation that will help CCR to move towards its goal of near real-time identification and surveillance of cancer throughout the state. It enables the governance structure and workgroups of CDMC to now build upon that framework of standardized data, electronic versus paper submission, and improved timeliness of reporting. It will allow the CCR to become a pioneer in the aggregation, management and clinical utility of cancer data. The CSP is continuing to engage with the CDMC as it works to develop policies and enhancements over current CCR operations we can revisit the specifics of the statutes contained in AB 2325