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Praxis Development

Changing business requirements within the NHS and changing technologies, as well as the changing requirements on cancer registries, have led to a need for a major revision to the PRAXIS software (Version 10):
  • The NHS National Cancer Data Set (NCDS) defines data considered to be necessary for the planning and management of cancer services and the monitoring of treatment outcomes. The cancer registry data items within the NCDS far exceed those supported by existing Cancer Registration systems.
  • The need for a redesign of existing database structures and the extension of data management facilities (input screens) for these additional data items. The technology on which the existing screens were based is now outdated (being restricted to 80 x 24 character presentations) and support is being withdrawn by the supplier.
  • The need for a new graphical user interface to support the revised database.

Progress to date

Much of the early work to progress a re-write of the software was undertaken in-house through PTG. A new database design was agreed and produced and various specifications drawn up to describe the functionality and look and feel of the data management screens and processes.

The data collection processes are currently different for each registry. Northern Ireland, Trent and the Manchester site of North Western/Merseyside rely largely on data submitted ‘electronically’ while the remainder work largely with paper-based source documents and manual data input. PRAXIS can support both these practices.

Recognising that insufficient capacity and technical expertise was available in-house wholly to support the development project, external commercial help has been sought. Financial Objects (FiO) were commissioned to prototype a limited development, known as Phase I.Further phases are currently being developed:

  • Phase II – development of the functionality and screens to support the manual entry and amendment of cancer data and the maintenance of reference material.
  • Phase III – support for the processing of batches of data received in computer-readable form.

These will be followed by phases to cover residual functionality and new requirements.

To date this work has progressed as a joint FiO/PTG project based on detailed design and specification documents produced by PTG. The work splits along the following lines:

  • FiO are developing a set of Visual Basic software, based on earlier work for the National Breast Screening Service, which allows the execution of application menus, screens etc within a modern graphical user environment and the interface of these with an existing database. This software resides on client PCs running Windows. They are also generating the parameters which define the actual menus/screens – these are stored within an Intersystems CACHE database. These components are known as the ‘front end’.
  • PTG is updating the existing Version 9 software to deal with the extended (CRDS) data set and providing new software to interface the registration database with the front end. This consists largely of components to retrieve data from the ‘back end’ database, format it for presentation to menus, screens etc and to act in reverse by posting processed data back to the database. All this software (and the database) resides on a server running the Intersystems CACHE product. In recent months the PRAXIS Board has contracted elements of this work to an independent developer, who is also responsible for assembling and issuing the front/back ends.
  • The Project Board (largely delegated via PTG) is responsible for overall management of the project, the contract with FiO and for liaison over design and technical issues. The work has been supported by a part-time project manager (due to finish end February).
  • PTG is responsible for undertaking testing of the resultant software.

Phase II work began in late 2004. The majority of software components have been produced. A cycle of software issue, testing, feedback and correction to both the front and back ends has been in progress for a number of months. The responses from testing of the latest issue (Build 1027) are being worked through at the moment.As of March 2006 most issues relating to Phase II of the development have been resolved.

Phase III work began in late 2005. The majority of the back end software has been produced and issued to FiO although there are some areas of the interface still under discussion. FiO have delivered initial versions of software to support sections 3 (Automated Batch Processing) and 6 (Batch Processing Configuration) of the Phase III Specification and these have been combined with the back end software and gone through initial testing by the independent developer. FiO are currently working on the remaining sections, Allocation Management and Manual Intervention & Resolution, with a delivery timescale of late/end February. PTG are drawing up a test strategy for Phase III.

New project management arrangements

Despite the best endeavours of PTG members and other registry staff the project to date has suffered from competing demands on each individual’s time. It is recognised that the consortium is essentially voluntary, with no resources under the direct control of one person.This has led to delays in the production of key components and the final production of a robust and reliable set of software to support the Cancer Registration process. These delays have caused postponement of some registries’ migration to Version 10; further delays will seriously affect their ability to meet the end of 2006 deadline for ‘electronic’ processing capability, and the ability to receive and process all the CRDS data items.

The PRAXIS Board has therefore reviewed the present situation and has agreed to appoint a project manager, contracted to work sufficient days to be able to manage the outstanding tasks effectively. The objective is to deliver to each member registry a robust and implementable Version 10 of PRAXIS which contains all the components of Phases II and III, by 31 May 2006.

The Board has also agreed that

  • Each PRAXIS registry Director will formally commit appropriate in-house staff resource for the lifetime of the project; the project manager will be able to allocate the required tasks to those resources-these tasks to have priority within the registries concerned as per the agreed project plan (see outline project brief below).
  • Each registry will plan its own implementation date, based on the knowledge that a working product will be available by 31 May 2006

Outline project brief

The following is an outline of the work involved:

  • Review the background to the project and become familiar with key documents.
  • Understand existing contractual arrangements with FiO and the independent developer.
  • Discuss with each registry the likely availability and skill mix of staff.
  • Identify the various components or functional areas which will comprise the deliverables within Version 10. These will include specifications, software, test data/framework, documentation etc.
  • Assess the degree to which each of these have been produced.
  • Identify outstanding areas of work and produce a detailed task list.
  • Assess the type and amount of resource required to complete these tasks.
  • Identify any other prerequisites, assumptions and risks.
  • Prepare a detailed project plan, showing tasks, resources and dependencies, for presentation to and agreement by the PRAXIS Board. (This inter alia will allocate tasks where necessary to appropriate registry staff).
  • Within the limits of this project, direct and manage the allocated personnel and project contracts. Work closely with the PRAXIS Technical Group.
  • Continually review progress against the project plan, taking action as necessary to rectify slippages.
  • Produce regular (weekly) highlight reports for the Board including a risk log.
  • Produce exception reports should the need arise, bringing to the Board’s attention matters which need rapid resolution.
  • Attend PRAXIS Board meetings, reporting progress and seeking action as necessary. These are scheduled to meet every 2-3 weeks between now and 31 May (by telecon if necessary), agreeing remedial action as required.
  • Ensure a working, robust, implementable PRAXIS Version 10 application is available to each consortium member by 31May 2006.

Contact Information

N. Ireland Cancer Registry
Centre for Public Health, School of Medicine, Dentistry & Biomedical Sciences
Queen's University Belfast
Mulhouse Building
Grosvenor Road
BT12 6DP

Tel: +(44)28 9063 2573
Fax: +(44)28 9024 8017

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