CIF changes - the what, the why and the how

As most of you learned the CIF will be changing and many of you had questions that pertained to – what we were asking for, why we needed it and how you would obtain and report it. So, to be clear we are collecting;

  • Creating a unique Client identification system – a number that is unique to that client and remains the same throughout and cannot be linked to the identity of a patient.
  • Stage of Cancer - if unfortunately a patient you navigated into mammography screening is diagnosed with cancer (0 in situ thru 4).
  • Linkages and the amount of time it takes for a women to get her breast health information resolved – for example if a women is deemed abnormal when is she scheduled for follow up or diagnostic (30 days, 60 days 6 months etc.) and from there if it is diagnosed as cancer when does she begin treatment (30 days, 60 days following her diagnosis). If it was found not to be cancer, how long was it from when she had her follow up to when she was told it was not cancer.

Why we Need it

It was suggested by the Avon Scientific Board that this information would provide a clearer picture as to access to care and the impact of BHOP funding. To show the effectiveness of BHOP requires client-level data including stage of cancer and linkages to care, therefore we need to follow clients throughout their journey from outreach, mammography screening and follow-up treatment if needed. This requires with tracking client using a non-identifiable unique client identification number. We had one webinar in February about these data reporting changes, and will be offering additional webinars as needed, so send your questions and concerns.

There is also a link for the CIF data dictionary here.

How You Will Obtain it

Unique Client Identifier
Many of you already assign a client identification number to your clients; please be sure that this number is unique to client but would not make them identifiable to us or others such as social security numbers, phone numbers or address. Make sure that it is a number that is easily recalled and would always remain the same, so that all staff could easily remember.
For those of you that are not assigning a Unique Client Identifier we provided an example, using the first and third and last letter of some ones name and two numbers of month and day of birth (e.g. Abigail McCulloch DOB 0424 – so it would be AIH0424 and no matter where she moved or what telephone number she had or where she was seen this data would never change but is not identifiable). If an outreach worker was fulfilling out a CIF outside a mobile unit they would not need a computer to generate a random number they could easily create the unique client Identifier.

Stage of Cancer
For those of you that are hospitals or clinics this should be easy, just remember we are asking for client level data not aggregate data. But for those that refer to outside hospitals and clinics make sure that you have a "Business Associates Agreement" which would allow you to get HIPAA protected information. Here is a link for an example of a "Business Associates Agreement"
You can also contact your clients directly and ask for stage of cancer if this diagnosis occurs.

Linkages to Care and Treatment
For this you need to have a good relationship with your clients and the treatment center; you can contact either to seen when they entered care and were seen or treated.

How is this reported to us

There are two ways this can be done; the first is to hold those CIFs where an abnormal was found and wait until a resolution is reported, then submit the CIF when you have collected all of the information. For those BHOPs using Ipads to collect CIF data or those that prefer to send in CIFs monthly for other reasons, you will need to develop a spreadsheet to track your clients using their unique Client identity number. Then on a monthly basis, send the spreadsheet in and the information will be updated in the BHOP Coordinating Center's database. We highly recommend that all BHOPs implement client-level tracking systems and we will be offering some examples in the next few months.