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Canisc Accordian file

Why is Canisc being replaced?

Canisc is being phased out due to the age of its software and it is no longer able to be flexible to meet the needs of the service and therefore patients.

Whilst Canisc allows multiple organisations to record the diagnosis, treatment and follow-up care information for a patient, it can only be accessed by approximately 2000 authorised health care professionals. It is a standalone application and the clinical care information within it is only visible via Canisc access. Patients receive care in many settings outside of the cancer centres and their cancer care clinical information is often not available to other health professionals treating patients for other health related issues in other care settings.

There is an urgent need for  a more secure, sustainable and accessible system which provides information about patients who have cancer across Wales, to those that care for them, when and where it is needed, regardless of the care setting.

The replacement Cancer Informatics Solution is one of the key enablers in bringing about strategic improvements in cancer informatics to facilitate the development and implementation of standardisation of clinical pathways and service transformation. This work will contribute in reducing unwarranted clinical variation and improving outcomes.

Who needs to use a Cancer Informatics System ?
  • Health Board Cancer Multi-Disciplinary Meetings and SPC Multi-Disciplinary Meetings
  • Health Boards Cancer Services Teams
  • Wales Specialist Palliative Care (SPC) Services
  • North Wales Cancer Services
  • Velindre Cancer Centre (South East Wales)
  • South West Wales Cancer Centre
  • Screening Services Wales (bowel, breast, cervical and colposcopy service)
  • Other organisations (secondary users of information) e.g. Welsh Cancer and Intelligence Surveillance Unit, Public Health uses clinical cancer data for cancer registration in Wales and the Wales Cancer Bank
  • National Clinical Audit Reporting and other audit and clinical governance processes at local, regional and national levels.
How will Canisc be replaced?

The Cancer Informatics Programme has been established to replace the functionality of Canisc across all Health Boards & Trusts in Wales. New features will be developed in user interfaces e.g. WPAS and Welsh Clinical Portal (WCP) to replace the functionality of Canisc, to support all stages of the cancer pathway and development of the single patient record. Clinical information required for the care of cancer patients will be made available to clinicians regardless of the healthcare organisation in which they deliver care.

The Cancer Informatics Programme has recently refocussed its efforts and established a phased approach with the initial acceleration phase prioritising twelve workstreams.  The primary objective is to rapidly replace the Canisc system, to mitigate risks to service provision and to provide business continuity for patient care.

Acceleration Phase Objectives (September 2021):

  • Mitigate risks to service provision and business continuity from legacy systems (Canisc)
  • Improve visibility of clinical information for Cancer care across Wales
  • Stable and scalable solutions underpinned by a safe and secure infrastructure
  • Communications and engagement with key stakeholders 
  • Business change facilitation, user engagement & training
  • Clinical Assurance & Approval 

After the initial acceleration phase has been delivered, the focus will then be on the enhanced Cancer Informatics Solution objectives in the post acceleration phases.

Post Acceleration Objectives:

  • Requirements not met in acceleration phase
  • Meet future service requirements and maximise opportunities for system connectivity across Wales 
  • Support enhanced auditing, cancer intelligence, service delivery and quality improvement  
  • Support quality improvement for service modelling and redesign
  • New functionality required to support patient pathway for cancer services and palliative care
Established Workstreams

Each workstream has a dedicated project management to coordinate the planning and timescales and will include elements of communications, business change facilitation and training / Elearning. Stakeholder engagement is essential for the workstreams and each will have clinical leadership and seek input from subject matter experts, Cancer Site Group (CSG) clinical engagement and health informaticists. The twelve prioritised workstreams are:

  • Data and Reporting
  • Inpatients
  • Outpatients
  • Multi-Disciplinary Meeting (MDM) Outcome Reporting
  • Palliative Care Applications/Functions
  • Radiotherapy Treatment Data
  • Radiotherapy IRMER Treatment Requesting
  • SACT Treatment Data
  • Screening & Colposcopy
  • Welsh Patient Administration System (WPAS) *
  • Adverse Reactions and Warnings
  • Investigation uploads

* Where new functionalities are required in patient administration systems engagement will take place with organisations who do not use WPAS.

What are the benefits in doing this?

Healthcare professionals who do not have access to Canisc will have visibility of the patient’s pathway and be able to see the clinical management of patients under their care at a national level on a 24/7 basis.

Developing Cancer information as part of the single patient record is enhanced by existing components of the single patient record described below.

Welsh Care Records Service (WCRS): A national clinical document repository which can be accessed by WCP users in any Welsh Health Board. This service provides the capability to view existing clinical documents and also create new documents using the e-Documents functionality. Documents such as Outpatient consultations, MDM records, handover notes, assessments and clinic and discharge advice letters are stored in this repository.

Detailed clinical information such as diagnosis, height, weight, vital signs, cancer staging will be recorded using e-Forms or via new cancer-specific functionality developed in WCP.

Welsh Results Reports Service (WRRS): The WRRS provides WCP and GP Test Requesting users the ability to view diagnostic reports and requests for their patient from Pathology and Radiology, regardless of the origin of production across Wales.

Access to the GP Summary Record from Welsh Clinical Portal (WCP): A summary of key information from a patient’s GP record is now available electronically for planned patient care, including during outpatient appointments via WCP.

National Intelligent Integrated Audit Solution (NIIAS): NIIAS makes it quicker and easier for Health Boards and Trusts to spot any unauthorised access to patients' electronic records, or potential data breaches. The solution intelligently processes audit logs from National clinical systems that contain patient records, within the NWIS portfolio of applications. The solution cross references this information with related national identity management systems holding patients/clients and users’ demographics. This produces a suite of audit reports that can be analysed to evaluate record access activity relating to the individual patient/client.

Cymru Login is a single sign on password for all national systems and forms part of Active Directory (NADEX / e-mail).

Master Patient Index (eMPI): This provides an enterprise Master patient Index that links patient identity records across a range of information systems. The result is a single ‘gold standard’ identity record to be used across national systems which will help minimise the number of duplicate records and support Health Board system mergers.

Welsh Reference Data Service (WRDS) & National Data Standards: Providing support for SNOMED CT to ensure data is appropriately coded and ensuring data lookups are consistent across applications; to allow better re-use of data for clinical audit purposes.

Alerts & Notifications: WCP will provide a generic notifications service allowing clinicians to be alerted to the presence of new diagnostic reports, new referrals and patient warnings; including when patient records are opened or when patient lists are viewed.

Welsh Clinical Communication Gateway (WCCG):  a messaging service that allows clinical documents such as referrals to be sent and the progress of the referral to be tracked.

Patient lists will be presented to WCP via patient administration systems.

What might this mean for me?

Replacing Canisc doesn’t replace the need for people but it may mean different ways of working and the system you use to carry out your duties will be in a different place.

The Cancer Informatics Programme is committed to supporting people with this transition and will ensure that adequate business change facilitation, training and E Learning materials are provided to support you. Additionally, Wales Cancer Network (WCN) will be establishing and leading on a workforce group designed to support all users in their roles.

Where can I get more information?

There is a TEAM: Wales Canisc Replacement that information is shared to for each of the workstreams. Detailed progress reports are provided weekly for subscribers to read at their leisure. Equally queries can be raised for any of the work streams to address. (NHS staff only).

WCN will post updates on this website and will be coordinating an event to provide information on each work stream in more detail and provide a forum for input or dealing with concerns and communications.