HemoBase: A Multidisciplinary Registration Systeem in Hemato-Oncology.

HemoBase is a patient oriented prospective hemato-oncology database using three central concepts:

1. Report periods;

2. Integrated Diagnosis;

3. Multidisciplinary discussion of patient data.

The disease history of a patient is divided in report periods. Each containing an integrated diagnosis, a treatment plan and a therapy evaluation. The integrated diagnosis is composed of an overall diagnosis, the topography of the primary tumor and the prognostic factors. A new integrated diagnosis or new treatment strategy leads to a next report period. Relevant clinical and diagnostic data and conclusions leading to the integrated diagnosis are registered according to the (mandatory) international guidelines and coding systems (anamnesis, physical examination, clinical chemistry, blood and bonemarrow cytology, flowcytometry, histology, genetic analysis (i.e karyotyping, PCR, FISH), imaging studies (i.e. CT including perpendicular diameter calculation, MRI, PET). Microscopic or other images may be imported. Furthermore, it is possible to record general medication and make follow up notes during patient visits or hospital stay. HemoBase contains algorithms to determine prognostic factors and a diagnostic multiple myeloma algorithm. HemoBase registers chemo-, radio-, surgical- or transplantation therapy, including (inter)national trials and registration of toxicity and infections. Dose regimens and dose reduction are calculated automatically. Therapy evaluation includes response evaluation and registration of cause of death. Plenary discussion of patients is facilitated by providing on screen the list of patients to be discussed with a direct link to individual data. Essential items of patient status are shown in a nutshell on a visual time axis. Using the query module one can evaluate patient data for quality, research and management purposes, i.e. patient outcome for diagnosis X with therapy Y, or more complicated queries. The housekeeping part of the system contains a personal task list and an internal mail module. Using the management module fields, forms and thesauri may be configured by the user according to the latest standards, i.e. a new therapeutic trial, a new translocation, a new WHO diagnosis etc. Access to Hemobase and to the separate datasets is linked to hospital function (account name) and password protected.

HemoBase an application based on internet technology, currently implemented in the Dutch language and running on a central server. For access to the application Internet Explorer 6.0 is minimally required. At present, HemoBase is being used for a year in 6 different hospitals and laboratory locations in one region of the Netherlands (pop. 600.000) connected by secure intranet technology. This will be increased gradually and a HemoBase board will be developed for agreement and monitoring of registration protocols.