Information Medical Practices and Hospitals

Obligation to report

Since 1 July 2014, hospitals, doctors' and dentists' practices or other medically managed facilities in Hamburg have been obliged to submit information on cancers, their early stages and benign tumours of the central nervous system to the Hamburg Cancer Registry (HKR). All physicians and dentists are still entitled to report (§ 2 Para. 1 and 2 HmbKrebsRG).

The obligation to report includes the continuous, complete and full transmission of information on the legally defined occasions for reporting. These define points in time in the course of a cancer disease after which the corresponding data must be transmitted to the HCR within eight weeks:

1. establishment of the diagnosis after sufficient clinical confirmation,
2. histological, cytological or laboratory confirmation of the diagnosis,
3. beginning of a therapeutic measure,
4. completion of a therapeutic measure,
5. determination of a therapy-relevant change in the disease status,
6. death.

Download: Notifiable diseases (ICD-10 codes and names)

Download: List of paired organs – Work aid

Download: ENCR Recommendations – Coding Incidence Date 2022

Uniform federal data set

The content and form of the reports are described in the law (§ 3 HmbKrebsRG). The reports are made electronically. The nationwide standardised oncological data set (formerly “ADT/GEKID data set”, since end of 2022 oBDS) of the Association of German Tumour Centres (ADT) and the Society of Epidemiological Cancer Registries in Germany (GEKID) for the basic documentation for tumour patients and the supplementary modules defines the information in detail. The current versions of the corresponding XML interface are available under the above links. The HKR is expected to accept reports under oBDS Scheme 3.0.0 beginning 1 December 2022.

Reporting fees

Reporting institutions receive an expense allowance for each new plausible and complete report processed by the HCR and not objected to by the funding agency. The prerequisite for this is that all necessary information is included and that the patient's health insurance fund and health insurance number or private insurance company are stated for each report. The form for reporting the account details for the reporting practice/hospital can be found here.
The National Association of Statutory Health Insurance Funds (GKV-Spitzenverband), the German Hospital Federation and the National Associations of Statutory Health Insurance Physicians, laid down more details on the reporting fee in the Cancer Registry Reporting Fee Agreement; the associated arbitration award of 24 February 2015 regulates the amount.
Deviating from this, in the case of non-melanotic skin tumours (ICD-10 C44), an expense allowance is paid out from state funds only for initial reports.
With regard to the VAT treatment of reporting fees, the Federal Ministry of Finance stated in a letter dated 8 May 2017: "By contrast, reports – for example for clinical cancer registration pursuant to Section 65c (6) SGB V (German Civil Code), in which patient-specific feedback is provided to the doctor after the evaluation of the transmitted data and further treatment measures required in individual cases can be taken as a result – are tax-exempt".

Duty to inform

Before the data are sent, each patient must be comprehensively informed in writing about the notification, the tasks of the Hamburg Cancer Registry and the right of objection in the case of an initial notification. Exceptions are defined in § 2 paragraph 4 HmbKrebsRG. The information material for patients is available free of charge.

Download: Template for requesting information material (by fax or e-mail)

Reporting portal

The free reporting portal of the HCR offers two options for the electronic transmission of reports: If the number of cancer cases is low, the necessary information can be entered directly via an input mask. Larger oncological institutions can send self-generated XML file packages via the Internet.

You can access the portal via the following link: https://hkr-melderportal.hamburg.de

You can find more information and an explanation of all the steps required for successful registration in the quick guide to the reporting portal, which is available for download.

Training

Portal and tumour documentation training course

The Hamburg Cancer Registry offers a free reporting portal and tumour documentation training course once a month. The training is suitable for medical professionals.

Content:

• Legal basis for the obligation to report to the Hamburg Cancer Registry
• Reasons for reporting according to the Hamburg Cancer Registry Act (HmbKrebsRG)
• Use of the detector portal
• Overview of the fields and their characteristics in the tumour documentation
• Classification and key systems:

                    o    TNM
                    o    ICD-10
                    o    ICD-O (Topography/Morphology)
                    o    OPS

oBDS 3.0.0 – Portal update

The Hamburg Cancer Registry offers additional dates on the topic "oBDS 3.0.0 - what's new?" The training is suitable for medical professionals.

Content:

• Changes in tumour documentation according to oBDS 3.0.0
• Overview of the new fields and their characteristics in the tumour documentation

Prior registration is required for all events.

Introductory texts and detailed information can be found in the Cancer Registration Manual, which was reissued in 2018. For information on version 3.0.0 of the interface of the nationwide standardised oncological data set (formerly ADT-GEKID data set), see here.

Feedback reports

Hospitals and practices with at least 60 reported cancer cases within five years – or upon request – receive a regular annual feedback report by e-mail, post, or for retrieval via the reporting portal. In addition to information on the number and completeness of clinical reports in the reporting period, patient numbers, diagnosis data on new cases and therapy data are evaluated for each institution. If there are enough cases, survival time analyses for selected tumour types are also presented.

Regional quality conferences

Twice a year, the Hamburg Cancer Registry invites treating physicians to regional quality conferences. The aim is the collegial discussion and use of clinically relevant evaluations of the reported data in order to further improve the quality of oncological care. Within the framework of a focal topic, such as certain tumour entities, results on epidemiology in the resident population of Hamburg, on clinical questions and on comparisons between institutions are presented.

The preceding documentation conference deals with data quality and is aimed at those responsible for tumour documentation and reporting in hospitals and practices.

Previous regional quality conferences of the Hamburg Cancer Registry:

Case documentation

The Hamburg Cancer Registry maintains electronic clinical case documentation to promote interdisciplinary, direct patient-related cooperation. In accordance with the Hamburg Cancer Registry Act § 9 paragraph (8), the clinical data documented in the registry are transmitted to the treating physicians on request for the patients they have reported, unless they have objected to the plain-text storage of their personal details. The transmission shall be carried out in compliance with data protection regulations.