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Spring 2023

Cancer Registries: Is Outsourcing a Better Option?
By Suzanne Neve, RHIA, CTR
For The Record
Vol. 35 No. 2 P. 18

Is Outsourcing a Better Option?

Seemingly endless backlogs of oncology data mounting? Not enough certified registrars to focus on the management of data? Tired of rising costs for the upkeep of a certified registry staff?

Many HIM, registry, and compliance leaders are grappling with these questions, and they are coming to several conclusions. One of them is to look to a trusted partner for help in navigating these challenges.

Outsourcing the leadership and staffing of a cancer registry can alleviate the headache of internal data collection and management for a multitude of reasons. Because oncology data management is complex and registries are often challenged with meeting deadlines, pressure can be taken off your own staff when there’s someone whose entire role is dedicated to the cancer registry function. While some of your staff’s roles include cancer registry processes, an outsourced partner can be 100% dedicated to completing those processes—accurately and in a timely manner.

Deciding on in-house or outsourcing opens a list of questions to contemplate. Will this be more advantageous for you financially? Can you rely on the partner to deliver as promised, knowing how critical timeliness and accuracy are for your success? How will you hold an external partner accountable?

Consider how health care organizations today are benefitting from an outsourced cancer registry program and the conclusions they’re reaching when evaluating their model.

Will Outsourcing Cancer Registry Reduce Costs?
When it comes to taking the leap into outsourcing, one of the biggest questions you may ask is, “what’s the cost?” You might be under the misconception that it will be more expensive to outsource than to run your own cancer registry. But the truth is you most likely will reduce costs by outsourcing your cancer registry program, with a visible return on investment within the first year.

This gives the added benefit of no longer having to worry about investing in training your own staff and ensuring they have the proper credentials.

Can I Trust a Partner to Conquer My Backlogs?
Backlogs in cancer registry are increasing at an alarming pace. With a lack of certified tumor registrars (CTRs) in the industry, a high rate of turnover, and the need for concurrent abstracting, completing your backlogs may seem hopeless. In some cases, data from 2022, 2021, and even half of 2020 are still being worked on. The consequences of overdue registries can range from a letter of warning to scenarios that may cost you significantly more than outsourcing would, all while damaging the credibility of your facility.

Having a vendor partner handle your cancer registry program can be a breath of fresh air. By bringing in a dedicated team of experts, you can begin to make a huge dent in a seemingly insurmountable backlog. In addition, making the investment to outsource your cancer registry program and creating a solid game plan for cutting down backlogs shows your state registry that your organization is making every effort to comply with regulations and deadlines.

What Level of Expertise Does an Outsourced Partner Bring?
Third-party cancer registry partners provide you with a credentialed staff who have deep knowledge and successful track records for meeting the required reporting standards at the state and national levels. Partnering with a staff whose credentials come from bodies such as the National Cancer Registrars Association; the Surveillance, Epidemiology, and End Results Program; the American College of Surgeons Commission on Cancer; and other state reporting facilities can help ensure a high level of competency, consistency, and ongoing training.

Many third-party cancer registry partners encourage their CTRs to hold dual credentials such as registered health information administrator (RHIA) and registered health information technician (RHIT) certifications, which adds to the level of experience and credibility that CTRs bring to their roles. RHIA credential holders have a comprehensive understanding of the principles of HIM, including data analysis, health IT, and privacy and security regulations. On the other hand, RHIT credential holders have a strong foundation in health data management, including data quality and integrity, coding, and data analysis. Credentialed professionals from outsourced cancer registry programs have wider access to development tools such as webinars, continuing education, and mentorship from more experienced CTRs. In addition to their intense education and training, third-party cancer registrars can also bring valuable perspectives as a result of having worked in outsourced programs at other health care institutions. Chances are, they’ve already encountered the challenges your organization is facing and can share with you what has worked and not worked for other organizations like yours.

Most third-party cancer registry partners have strict requirements for the registrars that they hire, including prior years of experience and a CTR certification. This level of background gives many outsourced registrars a wealth of information regarding the best ways to manage your cancer registry program. They also have access to a network of other CTRs who each have their own set of client experiences and may be better suited to meet specific standards involved. With outsourcing, you can feel confident in knowing that despite the limited population of registered CTRs, you’re reaching out to a resourceful pipeline of accomplished candidates with a history of excellent performance.

What Added Value Can a Partnership Bring?
Similar to the benefit of an outsourced registry’s knowledge and expertise, a partnership between a health care provider and an outsourced cancer registry partner can create opportunity, flexibility, and balance. A partnership allows an outsourced team to take full control of your cancer registry—enabling your own staff to maintain a singular focus on their main tasks. It creates a balanced ecosystem with a sensible workload, reduced stress, and mutual success for both parties. By using their own bank of resources, a partner can bring operational leadership and guidance to the table, along with a heightened sense of confidence that the job will be done accurately and on time. Additionally, while it’s often challenging for health care organizations to allow their staff to work remotely, by contrast, third-party partners who administer cancer registry programs are set up to allow their cancer registrars to work remotely, which makes these third-party companies attractive to credentialed professionals who wish to work from home. These third-party companies often have access to a nationwide network of cancer registrars who may be geographically out of a particular health care organization’s hiring radius. Ironically, however, even though these registrars may work remotely and are technically employees of the third-party outsourcing company if the partnership is a good one, it will feel like they are seamlessly part of your own team.

Outsourcing can be an effective solution for businesses looking to ensure continual coverage of staffing. When a third-party contractor is responsible for a specific task or project, their absence due to personal time off or other reasons can cause significant disruptions in the workflow. However, outsourcing companies often have a pool of talented professionals who can step in as fill-in CTRs when necessary, ensuring that the work continues to move forward without delay. This approach helps prevent backlogs and ensures that deadlines are met, which can ultimately lead to better outcomes and increased client satisfaction.

The world of cancer registry is full of complex and time-consuming tasks, and reporting deadlines always loom ahead. But the work of a cancer registry provides valuable information that plays an enormous role in improving cancer research and patient care. With the specialized skills that cancer registry management requires, a certified staff working solely on these cases can make all the difference to your organization. While some of your internal staff may be qualified for the role, they have numerous other tasks that they need to complete throughout the day. Trying to wear the cancer registry hat inevitably adds additional stress and pressure as they try to work through their endless lists of responsibilities. And what’s worse, this situation creates a hefty cancer registry backlog that makes meeting state and national deadlines almost impossible. In that case, it makes sense to turn to certified professionals whose role is focused 100% on cancer registry. Doing so can provide a wealth of benefits, including access to deep expertise and knowledge, reduced backlogs, an improved return on your investment, and better compliance with state and national mandates. And perhaps most important, when your cancer registry is run at its very best and organizes and collects data with the utmost quality and focus, it leads to better care and better outcomes for the cancer patients you serve. And, after all, isn’t that the true purpose of any cancer registry program?

— Suzanne Neve, RHIA, CTR, has been active in the cancer registry for more than 28 years and is the director of Cancer Registry Services for Medical Record Associates, where she oversees the operations of the cancer registry business line. She has extensive experience and knowledge working with Commission on Cancer–approved programs as well as state reporting facilities. Neve holds a BS degree in Health Information Administration from Long Island University-CW Post and is a registered health information administrator as well as a certified tumor registrar. She is a member of the National Cancer Registrars Association, AHIMA, and numerous state cancer registry associations.


How to Choose a Cancer Registry Partner

While there are many benefits to outsourcing your cancer registry program to a third party, finding the optimal partner for your organization can be a daunting task. The following are some tips to aid you in your search.

1. Identify Your Needs
Selecting the right cancer registry outsourcing partner begins with determining what your organization’s specific needs are. It’s important to sit down with your team members who normally perform the cancer registry task and listen to what they have to say about where your program may be lacking. Identify what your backlog is and what regulatory deadlines your organization may be missing. Make a list of things that could make your program better. Try to determine how many full-time staff would be needed to completely focus on cancer registry. Assess your budget. You may need to enlist the help of your financial department to ascertain how much money your organization may be losing due to inefficiencies in your program. This will help you decide what a reasonable budget would be for investing in an outsourcing program that would save money in the long run by curtailing those losses.

2. Interview at Least Three Outsourcing Companies
This will give you the opportunity to compare and contrast how different outsourcing partners work and to determine which you feel most comfortable with. Ultimately, your cancer registry outsourcing partner should become an extension of your organization’s internal staff and should seamlessly blend with your organization’s culture. After spending some time interviewing companies, you should be able to get a gut feeling about which would be most compatible with your organization’s needs and operating style.

3. Ask How They Measure Success
Find out how a potential cancer registry partner will prove its worth on an ongoing basis. Key performance indicators should be identified at the outset of the partnership, and then going forward, the partner should be able to quantify those metrics and provide that information in periodic reports to your organization. One of the most important items about which they should report to you is the productivity of their certified tumor registrars. Performance reporting not only helps you see how successful the outsourcing program is but also aids in making necessary adjustments along the way.

4. Ask About Their Communication Style
All companies have different communication styles, and it’s important to find an outsourcing partner whose style is in sync with that of your organization. Find out how often they will keep in touch. Will there be daily, weekly, or monthly phone calls/meetings? Be sure to include, as part of the contract, what a regular schedule for meetings/phone calls will be.

5. Ask About Their Knowledge of Compliance Requirements
A cancer registry partner should have deep knowledge of current credentialing and compliance requirements, including those of the American College of Surgeons Commission on Cancer (CoC), the National Accreditation Program for Breast Centers (NAPBC), and the Quality Oncology Practice Initiative.

6. Ask About Their Quality Assurance Program
A company should have a policy and procedures for performing quality assurance (QA). Quality is a core measure in any program, whether CoC, NAPBC, or state reporting. It’s important that the quality of work is measured and formal feedback is provided on a regular basis. At companies like Medical Record Associates, our QA program mimics the quality guidelines needed for CoC approval. With the recent change in the CoC standard 6.1 in the last few years, the cancer registry has taken on the full responsibility of performing QA for the CoC-approved programs. Ask to see a copy of potential cancer registry partners’ QA policy and procedures as well as a sample QA report.