Originally, the Breast Care Registry (BCR), formerly known as Breast Cancer Clinical Case Registry (BCCCR), was established to provide population-specific patient data required to ensure that quality health care services continues to be delivered in a timely manner. The BCCCR project was begun to establish a registry of information about breast cancer screening, test results, treatment, and follow-up for the purpose of clinical care and population surveillance of breast care. The registry provides a user interface for clinicians and coordinators to analyze and report registry data. The initial development contract for the registry came to an end with significant defects preventing its release, and a number of requirements that were not started or not completed.

To date, VHA has not had a mechanism to efficiently monitor Veterans who need screening mammograms, or to manage patients with abnormal mammograms, breast findings, and breast cancer. In addition, there has been a lack of ability to track care on a population level in order to monitor compliance and variance with guidelines, and timeliness of management of results and care. Without this ability, screening tests may be delayed or missed, and there may be delays in diagnosis to later stages requiring more invasive treatment and procedures, as well as delays in cancer care itself.

The current effort aims to complete the registry as originally conceived by completing initial requirements, repairing defects, ensuring that reports are consistent, ensuring that data is pulled accurately and completely from identified data sources, completing usability and integration testing, and releasing the full registry nationally. The enhanced Breast Care Registry (BCR) will provide the ability to determine areas for process improvements to ensure timeliness and quality of care for Veterans, enhancing VHA’s capacity to monitor program effectiveness and long term outcomes of Women’s Health programs.

The goal of the BCR enhancements project is to modify and enhance the existing BCR to provide the ability to support the analysis and reporting of information about breast care, including cancer screening, screening results, diagnostic test results, breast care services delivered, and follow-up for the purpose of clinical care and population surveillance around breast care. The enhanced BCR shall consist of a more useful and meaningful reporting user interface, in addition to a more streamlined and performance-improved backend database structure. Major enhancements are focused on the following capabilities: sorting, filtering, standard reporting, custom reporting, printing, saving, exporting, error handling, display, system performance, and new data elements.

Leveraging the Converged Registries Solution (CRS) architectural framework to facilitate development of the BCR enhancements, the standard data schemas exist for the core functionality of CRS and BCR. However, enhancements will be developed for the CRS patient seed and BCR data schema, and improvements for the BCR functional user interface will be implemented. The enhanced BCR will be able to produce higher quality data reports and comprehensive queries from information that is available in the Corporate Data Warehouse (CDW), as well as compile, sort, and filter patient demographic and clinical data.