Follow-up should be generated each month. A control list of patients due for follow-up is compiled and compared to hospital admission and outpatient records. If the patient has returned to the facility, records are obtained and appropriate information extracted. Some health information management departments automatically route the record to the cancer registry if a diagnosis of cancer is coded (whether coded active, metastatic, or "history of").
If the patient has not returned to the institution, follow-up letters are usually mailed to the managing or referring physician. Letters may be sent to other physicians involved in the care of the patient. If physicians have not seen the patient since the date of last contact, follow-up letters are then usually sent to the patient, family members, or other contacts.
Population-based registries initiate follow-up according to the rules and requlations at their institutions. Some registries send monthly letters to physicians when patients have not been updated for 12 months. Others send letters to patients or other contact sources. Additionally, population based registries often initiate follow-up with state or federal agencies such as HCFA, state vital records, etc.
If a response has not been received, letters are mailed to new sources until all potential sources have been exhausted. Follow-up procedures vary with different software systems. Letters can be generated individually or in a batch, depending on the software.
Attempts should be made periodically to contact all patients who do not have current follow-up including those considered lost to follow-up. By doing so, the registry can reduce the number of patients that are lost to follow-up and improve the registry's follow-up rate.