Since 2009, the AJCC 7th Edition Staging Manual to configure cancer staging summaries. Based on the information in that manual, physicians are able to properly stage cancers and decide what the TNM (and pTNM) scoring is for each tumor. The American Joint Committee on Cancer has been putting out such staging manuals since 1977 and have quickly become THE resource for physicians in summarizing the stage of cancers, even being adopted for use by such organizations as College of American Pathologists (CAP) and Canadian Partnership Against Cancer (CPAC) and as the best practice for many others, including the Commission On Cancer (CoC). Most importantly, the staging of the cancer drives the treatment the physician will prescribe to combat the disease. Not only is it critical that the cancer stage be correct, but that physicians are using the most up to date version of the Manual to deliver the appropriate (and most effective) care to the patient. And even though it has "America" in the title of the organization, the AJCC's staging summaries are the gold standard by which international cancer organizations also set their cancer staging standards.
This preamble is just to underscore how important the AJCC cancer staging summaries are to clinical care, pathologic workflows, and cancer treatments. It's also meant to highlight the importance of remaining current with the latest staging summaries, which have been the same for seven years. But now, on October 31, 2016, that's all about to change, as AJCC will be releasing their brand new 8th edition Staging Manual. This new set of guidelines will reinforce the staging steps that still work, while also introducing revisions and new components that physicians (including, if not especially, pathologists) must take into account when staging a cancer. Therefore it is in the utmost interest of physicians that they have adopted the new staging summaries as soon as possible. In fact, AJCC would like to see the new guidelines in use by January 1, 2017. There is a bit of a grace period for reporting using them, but pathologists are strongly encouraged to being using the new staging guidelines as soon as possible.
These staging summaries are the lifeblood of prescribing proper and effective care to cancer patients. Only by knowing the size, growth, and nature of the tumor can physicians truly understand with what they are dealing and how to best respond. Therefore it behooves everyone interested in best practices in medicine to stay up to date with the staging summaries, if only to make sure they are making the most informed decisions when deciding on a plan for treatment. But, while they are vital to administering care, keeping up with these changes can be burdensome on facilities. It can require multiple full-time employees to make sure they are incorporating the new formulas for determining the pTNM scores. That means staffing, time, and money has to go into keeping up with the best available information to deliver the best possible care. And at a time when money is tight, and many sites are expected to do more with less, that just may not be a viable option. Facilities (like pathology labs, cancer treatment centers, or hospitals) may be left behind not only in adopting the new staging but also in implementing the correct summaries and treatment plans. So how do organizations ensure that they are current with the most recent version of the AJCC staging while getting the most out of their resources? The answer is specialization.
Many health IT companies out there, particularly EMRs, offer multiple solutions for all of the ills of running a healthcare facility. They promise that their solutions can tackle this documentation, and that documentation, and this coding and that coding, and also keep track of inventory and medications and everything else one might need. And while many of them do a good job at a fair number of these claims, ultimately they don't specialize in maintaining any one aspect. To put it in business terms, they are an inch thick and a mile wide — they do many things but not all with any sort of depth or expertise, just the bare minimum needed to check off the box or get people to buy their system. But with specialization, those companies that focus specifically on one aspect of healthcare (like keeping compliant with AJCC cancer staging summaries) spend the time and resources required to know everything about that particular problem set. Not only do they know the ins and outs of the specific issue they are solving, but they also anticipate the needs of users and incorporate changes when need be (be it customization for the users or folding in the changes when updates occur).
AJCC provides an incredibly important, vital task in understanding cancer; by quantifying in a formula how the tumor is acting, treatment professionals can determine the best course of action for how to combat it. But in order for it to be of true value to physicians, it needs to be available to them in the context of their usual workflow. As the deadline rapidly approaches for adopting the new AJCC guidelines for staging summaries, it's important that people remember not only what is at stake for staying on top of the updates but they make sure they have the resources properly allocated for deploying those changes. It's easy to assume that it will be someone else's problem, or that it will be covered by some other system. But the fact is that it requires a dedication to understanding reporting guidelines and rules in order to properly ensure your facility maintains the best treatment it has always offered.
To learn more about the AJCC and their staging summaries, please visit their website. And for those interested in how to ensure your facility is up to date and delivering the best care possible before January 1, 2017, please contact us today.