Cancer Case Reporting Through Electronic Health Record Systems


The Ohio Cancer Incidence Surveillance System (OCISS) at the Ohio Department of Health (ODH) collects and analyzes cancer incidence data on all Ohio residents. Each physician, dentist, hospital, or person providing cancer diagnostic or treatment services is required by law (Ohio Revised Code 3701.262) to report all newly-diagnosed and/or treated cancers to OCISS. A reportable cancer case is defined as any primary malignant neoplasm, with the exception of basal and squamous cell carcinoma of the skin and carcinoma in situ of the cervix. Benign and borderline intracranial and central nervous system tumors are also reportable.

There are several options for reporting cancer cases to OCISS, one of which is electronic reporting from ambulatory healthcare provider electronic health record (EHR) systems in a Health Level Seven (HL7) Clinical Document Architecture (CDA) format. This method of cancer case reporting is a Stage 2 Meaningful Use (MU) menu set measure for eligible professionals.

Other reporting options can be found at: Reporting of Ohio Cancer Incidence Data

Is cancer reporting through an electronic health record system (EHR) appropriate for your practice?

If your practice DOES NOT diagnose and/or treat cancer, electronic cancer case reporting through an EHR is NOT appropriate.

If your practice diagnoses and/or treats a low volume of cancer cases, electronic cancer case reporting through an EHR may not be the best option for cancer case reporting. Please contact OCISS at to discuss.

How to get started:

Step 1: Determine if your EHR is capable of standardized cancer case reporting via HL7 CDA.

Find this information in the Implementation Guide for Ambulatory Healthcare Provider Reporting to Central Cancer Registries at

The Implementation Guide defines the trigger event and business rules for EHR systems to identify reportable cancer cases; define the specific data elements to be retrieved and included in the cancer event report; create a valid HL7 CDA cancer event report; and transmit the cancer event report to a public health central cancer registry over a secure electronic transmission mechanism.

Step 2: Create and validate test messages.

Validate test messages using the Meaningful Use HL7 V2 message validation tool:

Step 3: Determine transport mechanism and frequency of file transmission.

OCISS will work with you to set up a method of file transport. Secure file transfer protocol (sFTP) is preferred.

Step 4: Begin message format and content validation with the Ohio Department of Health.

Contact OCISS at to let them know you are ready to formally start message format and content validation. OCISS will conduct data quality analysis and provide feedback. This may be an iterative process.

Step 5: Go-Live

OCISS has confirmed accuracy and completeness of test messages and a secure transport mechanism is in place.

Useful links

Meaningful Use HL7 V2 message validation tool site: 

ODH Meaningful Use Stage 2 Policy for cancer case reporting:

Information on reporting of Ohio cancer incidence data: Reporting of Ohio Cancer Incidence Data

Contact information: