Vol. 11 •Issue 16 • Page 17
Making Updates to Cancer Registry Software
Donna C. Getreuer, RN, MSN, CTR
(Editor’s note: Registry Abstracts is a new column that will appear periodically in our print magazine and on our Web site.)
You had a great idea for your data system. Or, you found a problem with your system; a look-up is inaccurate or misspelled, perhaps your state registry notified you to start reporting on a new data element and you don’t have a place to collect it or a way to get it in your state-reporting file. Suppose the requirements from one of the national standard-setters changed and your system needs to be updated.
Why does it take so long for your system to be upgraded with new features and updates? One explanation is that a release schedule for upgrades is typically determined six months or more ahead of the distribution date to ensure that adequate staff and resources will be available. There is limited flexibility for unexpected changes. Software vendors utilize a disciplined approach (phases) to program changes.
1. Request phase: An idea, problem or new requirement is prioritized using an internal rating scale.
• Urgent: Quality issues that impede accurate data collection or reporting. May also denote a problem where the system is unusable.
• High priority: Important enhancements requested by many customers to substantially improve efficiency or effectiveness.
• Moderate/Low: Good ideas to improve usability, but other requests and requirements may have to take precedent.
• Deferred: Not feasible because of technology restrictions, resource limitations or inconsistency with the direction of development.
2. Investigation phase: Submitted requests are evaluated to determine resources required and consequences for implementing or not implementing the proposed changes. Decisions are made as to when and how changes will be implemented.
3. Specification phase: Determine how changes impact other parts of the system. That is, if you change one piece of code, how will it affect existing code?
4. Development phase: Corrected specifications are coded or programmed. Engineers ensure the software performs properly, document what has been changed and turn the product over to testers.
5. Testing phase: Testing may be done internally, especially in the case of new features or entirely new software, or it may be done at customer sites (considered “beta sites”). Vendors and customers frequently underestimate the time needed to complete this phase.
6. Packaging phase: User documentation, release notes, upgrade or installation checklists, system requirements, training guides and other instructional materials are created. An installation program is developed and tested for every supported operating system and all conceivable hardware configurations.
7. Release phase: The upgrade is distributed to a limited number of customers, usually following a regional distribution pattern. Distribution is typically staggered to allow customer support staff adequate time to respond to questions and problems.
Finally, you have your software, with your request included! Now all you need to do is install it! A word of advice for wise registrars:
Read and re-read the literature that accompanies the release. Maintain a filing system to retain all release literature. Above all, good practice dictates making and testing a back up of your database prior to installation.
How long will it take to complete all seven phases? The time varies with the type of request. Standard-setting agencies unfortunately often distribute new requirements with short implementation times.
Because most new requirements necessitate a database change or conversion, they should be expected to take about six months to complete. New requirements are also the reason some wonderful ideas and requests are delayed, because registrars must keep up to date with the standards while providing quality data to their facilities and state agencies.
What can you do to help this process? Keep sending ideas and requests to your vendor, because that is how any system matures–by incorporating ideas from day-to-day users who want to improve it. When you send ideas, document what problem it will solve for you–this gives your vendors information for setting priorities. Don’t forget to volunteer to be a beta site. Your contribution counts! n
Donna C. Getreuer is the senior product manager for cancer registry systems at IMPAC Medical Systems Inc. Prior to IMPAC, she has more than 10 years’ experience in the development and implementation of hospital information system software. She is also a newly certified tumor registrar and a veteran oncology clinical nurse specialist.