Minnesota Cancer Reporting System (MCRS)
Related Sites
Contact Info
Pathology Labs - How to Submit Data to MCRS
The Minnesota Cancer Reporting System (MCRS) requires medical laboratories to submit pathology reports that could lead to or refine a diagnosis of cancer. The MCRS will use the data to work towards its mission to promote, protect, maintain, and improve the health of all Minnesotans by tracking the occurrence of cancer within the state of Minnesota.
This webpage contains the necessary specifications for the implementation or sustainability of electronic data submissions from a pathology laboratory or pathology laboratory information system to the MCRS.
Useful Links
- MCRS reportability dates for specific cancer sites, 1988 to date. MCRS Reportability Dates (PDF).
- List of the reporting requirements, exclusions, acronyms and ambiguous terms. Reportable list - Reporting Requirements (PDF).
- The Centers for Disease Control and Prevention (CDC) produces guides for reportable ICD 10 CM codes. These Excel files contain “core” and “expanded” lists of ICD-10 codes that indicate a cancer diagnosis. These lists can be used to filter and report cancers if the pathologist codes a diagnosis using ICD-10-CM on every specimen. Note: MCRS requires both the "core" the “expanded” list.
- Centers for Disease Control and Prevention (CDC)-NPCR: Advancing Electronic Reporting.
Determine Reporting Format
MCRS accepts electronic pathology laboratory reports in standard formats defined by the North American Association for Central Cancer Registries (NAACCR). Files can be in HL7 version 2.3.1 (preferred current format), HL7 version 2.5.1 (future format) or pipe delimited flat file format. More specifics for HL7 format can be found at NAACCR- Pathology Laboratory Electronic Reporting, Volume V. NAACCR no longer supports the pipe delimited format, but instructions still exist in Chapter 3 of the Pathology Laboratory Electronic Reporting version 2.2.
Please note that our preferred format is HL7 version 2.3.1 or 2.5.1, and pipe delimited is only an option for pathology laboratories that are not able to report in HL7 format. Pipe delimited files will be converted to the appropriate HL7 version at MCRS.
If your pathologists practice synoptic reporting, Chapter 3 of the Pathology Electronic Reporting Version 4.0 will be helpful to you.
Setting up Data in a Standard Format
Using the NAACCR Pathology Laboratory Electronic Reporting, Volume V determine what fields from your current laboratory information system will map to the H7 standard record format version 2.3.1 (our preferred HL7 format). The fields that are listed on the file include required fields that if available, are to be submitted to the MCRS. This will be a helpful step to know if the laboratory is ready and/or capable of sending MCRS the necessary data elements.
If you are using the pipe delimited flat file format and need assistance send an email to health.mcrs@state.mn.us and we will help with the mappings. Information on the pipe delimited flat file format can be found in chapter 3 of the NAACCR Pathology Laboratory Electronic Reporting version 2.2.
Transmission of Files
Once the electronic record format has been determined, confirm the transmission mode that will be used for sending files to MCRS.
- MCRS recommends using the Public Health Information Network Messaging System (PHINMS), a free and secure data transfer software package created by the Centers for Disease Control and Prevention (CDC). The PHINMS software ensures that data transmission is performed securely, encrypted properly while automating retries, guaranteeing delivery once and only once, and using a standard HTTPS port (443) that is supported by most organizational firewalls. For information on PHINMS messaging, visit the CDC’s PHIN Messaging System Page.
- The Minnesota Department of Health File Transfer is an application for external partners to securely share files with specific contacts at the department. You will need a username and a password to access the application. To obtain a username and password send an email to health.mcrs.upload@state.mn.us.
Queue and Prepare for Onboarding
Complete the Laboratory ePath Onboarding Form and send it via email to health.mcrs@state.mn.us. After the Laboratory ePath Onboarding Form is received by the MCRS, a representative will contact you to gather further information to assess the facility’s readiness for electronic submission testing, provide additional information if needed, place the pathology laboratory into the onboarding queue, and agree upon an estimated date for the testing process to start.
Testing Process
MCRS will reach out to the pathology laboratory before the estimated testing start date and verify an actual date for the pathology laboratory to send a test file(s).
The testing process will consist of receiving a test file from the pathology laboratory via transmission as determined above (PHINMS or MDH File Transfer Webpage). MCRS will manually view the data within the test file(s), load the test file(s) into our test database, and communicate our results back to the pathology laboratory. This process will continue until a valid test file is obtained. The testing process will verify that the required data is being sent, the HL7 format is correct, the content is valid, and the data load into the MCRS database correctly.
Frequently Asked Questions (FAQ)
Q: Are laboratories required to report to MCRS?
A: According to the Minnesota Statutes, chapter 144, section 144.68 and Minnesota Administrative Rules, chapter 4606, part 4606.3305, Subp. 3, pathology laboratories are required to report data and to allow MCRS staff to inspect records to verify the accuracy and completeness of reporting. With automated electronic lab reporting, your lab will no longer need to find a location within your facility or provide a method for your MCRS Field Service Representative to review reports for that purpose.
Q: What if my laboratory does not have the resources to submit electronically?
A: The laboratory can still submit to MCRS via paper path reports, although it is not preferred. Send an email to health.mcrs@state.mn.us and we will provide you with the information necessary to send us paper path reports.
Q: What information is required to be reported by the laboratories?
A: Patient identifiers such as medical record number, full name, birth date, sex, address at time of diagnosis, race and ethnicity (if available), and social security number (if available) are required. Specimen date, reporting date, ordering physician, managing physician, pathologist, reporting facility, and ordering facility information are also expected. Furthermore, text from the body of the report is required that includes the clinical history, nature of specimen, gross pathology, micro pathology, final diagnosis, synoptic reporting, comments, supplemental reports, and staging. For more information, please see Minnesota Rules, chapter 4606, part 4606.3304.
Q: What if the lab is not able to provide all demographic information?
A: MCRS will work with your laboratory to see if there are other sources available for demographic information.
Q: Is there a required timeframe or frequency for submitting reports?
A: Medical laboratories are expected to report all cases of cancer within 15 working days of the date of diagnosis. For more information, please see Minnesota Administrative Rules, chapter 4606, part 4606.3303, subpart 2
MCRS prefers to receive one daily file that represents one day’s worth of pathology reports. This can be subject to change depending upon the laboratory’s volume of reports and will be discussed during the testing process.
Q: What types of laboratory reports should be sent to the MCRS?
A: All pathology reports (excluding pap smears) are expected to be sent to MCRS. If your pathologists practice synoptic reporting, these reports should be included and sent to MCRS. For information on the format of synoptic reports, review Chapter 3 of the NAACCR-Pathology Laboratory Electronic Reporting Version 4.0 page.
MCRS uses the AIM (Artificial Intelligence in Medicine, Inc.) system, which screens the pathology reports for reportable terminology before the reports are sent to our database. The laboratory can choose to filter their reports by using the MCRS Reportability Dates (PDF) and the Reportable List – 2018 Reporting Requirements (PDF), or, if an ICD-10-CM diagnosis is provided for every specimen, by using the Centers for Disease Control and Prevention (CDC)-NPCR-Advancing Electronic Reporting. The laboratory is expected to monitor and update their criteria yearly or whenever new documentation is provided by MCRS or CDC.
Q: What if my laboratory already submits to the MCRS but we are upgrading our LIS?
A: Contact the MCRS at health.mcrs@state.mn.us if the laboratory is switching to a new LIS or upgrading the current LIS. The pathology laboratory files may need to go back through the testing process.
Q: Is the data protected by data privacy laws or HIPAA?
A: Yes. See the MCRS Legislative Authority page for more details and links to HIPAA and Cancer Reporting.
Q: How long can we expect the onboarding/testing process to take?
A: Once the laboratory is placed into the MCRS onboarding queue, MCRS will send you an estimated time line. The onboarding queue wait time is dependent on the number of other laboratories that are also in the onboarding queue prior to your inquiry.
The testing process can be lengthy. For the MCRS, it is a manual process to look at every case that is sent in each test file. The duration of the testing process is dependent upon communication between the MCRS and the laboratory, LIS information availability, IT resources, and volume of cases. If all parties involved are responsive, available, and have the resources we have found that the testing process can be accelerated.
Q: Is there a cost associated with the testing process?
A: The only costs associated with the testing process are for the resources needed within the pathology laboratory. MCRS does not charge for the testing, onboarding, or production processes that MCRS staff perform.
Q: Are there other laboratories with the same LIS who have successfully onboarded? Can they be of assistance?
A: MCRS will know if other laboratories with the same LIS have successfully onboarded and can use the knowledge from previous onboarding to assist in the process. MCRS will work through any issues with your laboratory. If obstacles are encountered, MCRS will refer to the CDC and/or reach out to other laboratories with the same LIS to see if they would be willing to provide any assistance.
Q: How can I construct the HL7 message if I have CAP eCC synoptic reporting?
A: Reference page 128, 3.4 Rules for Constructing the HL7 message for CAP eCC Synoptic Reporting, found within the “Pathology Laboratory Electronic Reporting Version 4.0 – April 2011” on the NAACCR website NAACCR Pathology Laboratory Electronic Reporting, Volume V.