Development of reports containing health indicators generated with data extracted from cancer data management software
This report describes the Master of Health Informatics internship undertaken by James Wills at the Nova Scotia Breast Screening Program (NSBSP) in 2011. NSBSP is mandated to provide early detection of breast cancer through breast screening mammography and it oversees the entire patient journey including diagnostic testing, pathology, and surgery. As part of an update to the NSBSP health information system, the primary objective of the internship was to update the Program's Annual Report to use the new system as its source of data. The Annual Report provides information about the operations of the Breast Screening Program as well as nationally de ned health indicators for breast cancer and breast screening and is submitted to clinicians and administrators at the provincial and national levels. The internship was successfully completed with positive feedback from colleagues and managers. In addition to achieving the primary objective of updating the Annual Report, contributions were made to restructure the report, add GIS mapping, provide customization for future reports, and create a new plug-in to calculate breast cancer risk. The work was closely related to the eld of Health Informatics speci cally focusing on coursework topics such as health indicators, clinical work ow and information use, screening bene ts and harms, statistics, research methods, and project management. Opportunities to improve patient family history records became evident during the internship. Accuracy of self-reporting can be limited for second-degree relatives and routine biennial breast screening may not be frequent enough if a woman's risk of breast cancer has risen due to a family member's diagnosis. A Health Informatics solution is proposed that would allow breast cancer patients to share their diagnosis with family members and the relationship to be explicitly recorded in the NSBSP information system. Family members would be noti ed that their breast cancer risk has increased and have their screening plan modi ed if necessary. The proposal details software requirements for this solution and outlines the technical solution that would be required. Concerns around privacy, additional paperwork, and non-biological family members are discussed. The successful completion of the internship, including the primary objective and additional contributions, has resulted in several recommendations. The e orts made during the internship have allowed NSBSP to continue generating the Annual Report and develop new reports using the newly created components. The proposed solution for proactive family history recording should be considered for the additional bene ts it provides to patient care.