COMPUTER DATABASE FOR MELANOMA - A CLINICAL MANAGEMENT AND RESEARCH TOOL TO ENSURE CONTINUOUS QUALITY ASSESSMENT

The need for an efficient method to handle data and for chart document ation is more apparent today than at any time in the past. High volume clinics for screening, diagnosis, and treatment are the rule rather t han the exception in modem practice. A papermill medical record depart ment or tumor registry fails on a day-to-day basis because of ineffici ency of data collection, filing, storage, and abstraction. Requirement s of the Joint Commission for the Accreditation of Health Care Organiz ations (JCAHO) include the setting of standards and the ability to que ry data to ensure the standards are met. A PC-based software program h as been developed with the following features: (1) ongoing timed queri es of the data are possible on any variable collected in the database to monitor trends in the standards established for care in-the clinic; (2) a daily update of the database is performed so that it may be use d as a clinical management tool, acting as an electronic medical recor d or as a clinical research tool; (3) the software will summarize the chart by abstracting a predetermined list of key data elements to impr ove clinical efficiency; (4) chart documentation is improved for Medic are coding requirements to maximize. physician reimbursement; and (5) clinic notes and referral letters are generated the same day as the cl inic visit to allow patients to have a copy of their clinic notes or f or same day FAXing to the referring doctors. To date, > 1,200 patients with melanoma have been registered and entered into the system. The s ystem acts as a melanoma database for the State of Florida by register ing 10% of the new cases diagnosed in the state. The use of the databa se allows the natural history of various subgroups of the melanoma pop ulation to be defined in a state in which the disease is ''epidemic.'' In this way, populations can be identified who have a good prognosis and can just be followed or other subgroups identified who are candida tes for adjuvant protocols.