Exploring the College of American Pathologists Electronic Cancer Checklists: What They Are and What They Can Do for You

In order to make use of the eCC, the end user (the pathologist) must have access to a laboratory information system or to a third-party vendor that integrates the eCC into the pathology report.1 The dependence on vendor support creates variability in the implementation of the eCC product, with regard to both data input by individual pathologists (Figure 1) and data presentation to end users (Figures 2 and 3). Examples of variability in input include how in-form prompts (prompts within the form) are displayed and what restrictions are placed on the entered data (eg, numbers versus text strings), whereas examples in variability in data presentation include the ability to apply modifications like text formatting (bold, italics, underline) and other data display options (such as 2-column format versus paired indented) (Figures 4 through 6). [...]there are problems inherent to a narrative style of reporting, which include a lack of consistency in organization and the potential to miss or underreport critical data elements.2-8 In 1986 the CAP Cancer Committee addressed this issue when it established the first set of cancer protocols with its "Guidelines for Data to Be Included in Consultation Reports on Breast Cancer, Bladder Cancer, and Hodgkin's Disease. Notably, it introduces an interoperability source of error, as different sites may select different UOMs; it complicates data mining efforts as nonstandard variables are introduced; and it may contribute to the end users entering an incorrect value (mistaking the expected UOM). [...]it is best if the eCC vendor supports only the encoded UOM, as well as clearly defining the UOM on the data entry form and the report output.