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Follow-up should be generated each month. A control list
of patients due for follow-up is compiled and compared to
hospital admission and outpatient records. If the patient
has returned to the facility, records are obtained and appropriate
information extracted. Some health information management
departments automatically route the record to the cancer registry
if a diagnosis of cancer is coded (whether coded active, metastatic,
or "history of").
If the patient has not returned to the institution, follow-up
letters are usually mailed to the managing or referring physician.
Letters may be sent to other physicians involved in the care
of the patient. If physicians have not seen the patient since
the date of last contact, follow-up letters are then usually
sent to the patient, family members, or other contacts.
Population based registries initiate follow-up according
to the rules and requlations at their institutions. Some registries
send monthly letters to physicians when patients have not
been updated for 12 months. Others send letters to patients
or other contact sources. Additionally, population based registries
often initiate follow-up with state or federal agencies such
as HCFA, state vital records, etc.
If a response has not been received, letters are mailed to
new sources until all potential sources have been exhausted.
Follow-up procedures vary with different software systems.
Letters can be generated individually or in a batch, depending
on the software.
Attempts should be made periodically to contact all patients
who do not have current follow-up including those considered
lost to follow-up.
By doing so, the registry can reduce the number of patients
that are lost to follow-up and improve the registry's follow-up
rate.
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