Department: Data Abstraction Support

Division/Location: Direct Difference – Support of contracted facility as designated

Skill Set: Cancer Registrar Data Abstractor

Job Summary/Purpose:

Performs clinical auditing and data abstraction of patient records in support of contracted facility’s clinical process improvement and patient safety initiatives associated with participation in various quality data reporting systems. Results of audits and identified trends are reviewed with staff identified by contracted facility to include Quality/Performance Improvement team members, Service Line Coordinators/Directors, and others as specified by contracted facility.

Minimum Qualifications:

Education: Graduation from an accredited school of nursing as an LPN or an RN
Experience: Minimum 2 years’ recent experience clinical data abstraction of Tumor/Cancer Registry associated with current version/definitions.
Licensure: Must be licensed by State Board of Nursing

Education and licensure requirement may be waived if 3+ years’ experience clinical data abstraction with outside validation results > 95%.

Other Preferred: Certified Tumor Registrar, completion of NCRA certification exam :

Must maintain competency and knowledge of data definitions and reporting guidelines.
Must possess knowledge of anatomy and disease processes.
Must be computer literate and knowledgeable in spreadsheet software, database programs, Microsoft Office software.
Must be self-directed to troubleshoot computer issues associated with mapping network drives, installing software, and connecting to contracted facility thru remote access (VM Ware, AnyConnect, etc.)
Requires flexibility in work schedule.
Must complete and pass HIPPAA compliance training on hire as contractor, and annually.

Data Abstractor Guide

The Clinical Data Abstractor’s key responsibility is to collect and submit accurate, complete, and timely data to the specific registry or measure data repository while maintaining all HIPAA standards to maintain the safety and security of Protected Health Information (PHI). This task is accomplished through high-quality data compilation, documentation, and data entry of identified procedures performed and/or disease process treatment at the Contracted Facility into the associated registry/vendor tool platform.

Specific Responsibilities and Capabilities

Data Collection and Reporting

Reviews patients for inclusion in the specific data measure/registry as identified by the facility.
Collect related clinical data (complete summary of the history, diagnosis, treatment, and disease status for every cancer patient) as defined by the Cancer Registry/measure steward through efficient utilization of the hospital medical record systems.
Identifies streamlining, documentation, and process improvement opportunities in the data collection process.
Responsible for the accurate, complete and timely entry of data into the program’s database.
Maintain accuracy threshold of greater than or equal to 95 percent.

Work Effectively with Hospital and Individual Surgeon Office Staff

Serves as an educational resource on the specific measure/registry for internal and external audiences as needed.
Communicate clearly any data documentation needs to support accurate and high reliable data collection and reporting.

Timely and Effective Communication

Routinely check Direct Difference e-mail daily while supporting an ongoing account, weekly while waiting for an assignment
Routinely check Contracted Facility e-mail, at least every other day, while supporting an ongoing account.

Preferred Related Support

Participates in program teleconferences.
Participates in data compilation for audits and (re)accreditation or site visits.
Periodically attends voluntary in-person professional development seminars offered at various annual meetings related to experienced data measure/registry set.

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