Aim
The optimal care pathway (OCP) for people with oesophagogastric (OG) cancer defines the optimal times between key stages in the patient journey, such as diagnosis and first treatment. The aim of this study was to determine the extent to which the OCP for people with OG cancer could be mapped across two regional Victorian hospitals – one public and one private.
Method
The cohort for this analysis comprised all patients who were newly diagnosed with OG cancer (International Classification of Diseases and Related Health Problems [ICD]-10 diagnosis codes C15 and C16) at two regional Victorian hospitals over the 18-month period 1/7/16-31/12/17. Eligible cases were ascertained using data from the Victorian Cancer Registry. In preparation for retrospective auditing, the service system and data systems were mapped to identify the best source of data for each key OCP field. Six key OCP dates were then obtained from the paper and electronic records kept in the two health services. The proportions of dates captured were calculated.
Results
Overall, 62 OG cancer patients were included in this data mapping exercise. The proportion of OCP dates captured ranged from 84% for date of first specialist appointment to 100% for date of OG cancer diagnosis. In order to achieve this extent of data capture, auditors invested significant time and effort in reviewing eight structured and unstructured hospital databases as well as paper-based medical records. Consistency checks and data cleaning were also required.
Conclusion
While it is currently possible to map the OCP timelines for most OG cancer patients at the two regional Victorian hospitals, there is a considerable amount of work involved in obtaining key dates from multiple data sources. The Loddon Mallee Integrated Cancer Service is in the process of advocating for the inclusion of key OCP dates in electronic medical records at regional hospitals.