Structured Report Assistant
G UIDE FOR PATHOLOGISTS
What do I need?

a modern browser – ideally Chrome or Firefox, or a recent Internet Explorer; IE 8 and
above will work (Older versions of IE are not supported)

access to the Health Network (Connected Health, which your laboratory or hospital
normally provides)

this address: https://nzcr.moh.health.nz

your HPI CPN number, which is in your invitation email (and on your practising
certificate) and will look like this: 10ARTN

your password.
What are the password requirements?
Your password must:

be at least 8 characters long

include at least one of all these: a punctuation mark or symbol, a number, an uppercase
letter and a lowercase letter.
P@ssword1 meets these format requirements but is clearly not secure – don’t use it! Choose
a password unique to you, that you’ll remember easily.
When you first log in, you’re prompted to change your password from the temporary one sent
in your email invitation. The temporary password is a single use password, so you do need to
change it straight away.
After that you’ll need to change it every 90 days. These are security requirements set by the
Department of Internal Affairs.
What if I forget my password?
Click the forgotten-password link on the log-in screen and follow the instructions.
Alternatively, call 0800 505125 or email onlinehelpdesk@moh.govt.nz
How do I create a report?
Enter the accession number – your lab might call it a Daybook number.
Enter the NHI number of your patient.
Choose the cancer type from the list and click Create.
Check that the patient details near the top of the screen match your patient.
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Does the system automatically save my report?
No, reports don’t auto-save, so we recommend you save frequently - for instance, at the end
of each section.
Especially, save your report before you leave your station. You can save and stop working on
the report at any time and return and continue later.
What happens if I get interrupted?
Your session will time out after 15 minutes of inactivity (another security requirement). If
you’ve saved your work, nothing is lost. Just log in again – it may take you right back to where
you were.
To continue later, say the next day, click on your draft report in the menu.
Who has access to my report?
Everyone in your laboratory who can access the Structured Report Assistant can search for any
report for your laboratory, by accession number or the patient’s NHI number.
So one person can answer the macroscopic questions, another can continue with the
microscopic section.
Do I have to complete the macroscopic section of the draft report?
Yes, it is required as part of the protocol and some answers in the macroscopic section are
used to populate later sections .
Which questions do I have to answer?
Every question with a red * is part of the protocol Standards. These make up the minimum
dataset.
If you miss one, the Assistant will mark it in red on the progress bar, when you click Complete.
What about the G fields?
If an optional G question is not relevant to your case, leave it out. You can unselect an optional
choice if you clicked it by accident.
I am busy. Isn’t this report far too long?
It matches the RCPA protocol, which is considered to be best practice. Although the checklist
looks long, you can usually answer the questions quite quickly. When all the mandatory
questions are answered, you get the completed plain-text view, which is much more compact.
Do I have to complete questions with negative answers or that I consider irrelevant?
Yes, the RCPA requires all Standard questions to be answered. This includes questions for
which the answer is 0 (such as 0 nodes with micrometastases) because the absence of
information is not considered to be proof of absence. G fields can be omitted.
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Should I enter units, g or mm for instance?
No – just enter the value. The checklist shows the relevant unit in empty fields, until your
cursor reaches the field. Then it clears the field ready for you to type. (Note - Some browsers
don’t show the unit at all.) The Assistant remembers the unit and puts it into the plain text.
Must I repeat details that are already in my LIS report – block IDs and so on?
Only if you wish to.
For a text question, an answer like ‘See report’ is valid.
For tables, such as the list of cassettes and nodes, it’s valid to make a one-line summary, such
as ‘All cassettes 19’.
Or you can fill in all the details, perhaps while you do the macroscopic testing. (Try it with
voice control.)
How do I manage table rows?
Add more rows: below the table, change 1 to the number of rows you want, then click the
Add button. (Give it a moment.)
Get rid of a row if you’ve added too many: click the red x button at the end of the row.
(The first row never disappears, but values in it are cleared if you click the x button.)
What if a question isn’t clear to me?
Click the ”?” at the end of the question.
The Assistant opens the protocol comments for that question, in a new browser tab. The
checklist stays open in its own tab.
When you’ve finished with the help text, close that tab to go back to where you were.
(If you accidentally close the checklist, just log in again and choose your draft. If you save
often, most of your report will still be there.)
I clicked Derive, but nothing happened.
Some sets of options have a Derive button at the start or end and when you click it, the
Assistant will attempt to select an option for you. It can’t always choose an option, however.
For instance:

in the lung report it can choose NX or N0, but you have to choose N1, N2, or N3

some combinations of TNM values don’t have a stage grouping.
You can change a selected option, and you can edit derived text, for instance to add prefixes to
the stage grouping, or to modify the diagnostic summary the Generate button produces.
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What are the numbers at the top of the page for?
The numbers in the progress bar correspond to the question numbers. They show which
questions have been appropriately answered or not. They can also be used as a shortcut to get
to a particular question – click 17 in the progress bar to go straight to question 17.
If a table has optional parts, the progress bar only shows that question as complete (solid blue)
when everything, including the optional parts, has been answered. Note – if you don’t answer
all the optional parts, you’ll be able to press Complete anyway, as the system knows these
sections are not mandatory.
Some checklist questions are only visible if you choose certain options – you can see them
appear in the progress bar.
A red outline on a progress-bar number means a problem must be fixed. Start with the first
red number.
How can I see the plain-text version?
Click the Save followed by the Complete button at the top right. If all the mandatory
questions have valid answers, the Assistant generates the plain-text view.
When you’ve checked this view, click the Select button to select the whole report (even if you
can’t see it all on the screen). Use your usual copy-and-paste method to copy it straight into
your laboratory information system (for instance, ctrl-C, ctrl-V).
If your laboratory information system needs the report in separate sections, click the Sections
tab at the top. You can Select each section separately.
What if I want to change the plain-text version?
Click Edit at the top right. Make your changes in the checklist answers, save, then click
Complete again.
Can I amend the report in my laboratory information system?
Yes, pathologists can modify the plain-text output from the structured report, when it's in their
own system. For instance editing the macroscopic content, stripping out questions they don't
feel are relevant, and changing the layout and punctuation. They must meet the requirements
of their surgeons and of the RCPA.
Modifying the plain text will reduce the benefit of consistent results from standard protocols,
and compromise the ability to parse the HL7 data in the NZCR system, if this is implemented in
future.
How can I delete a report?
You can’t. However, only those reports you copy into your lab system are sent to the
requesting clinician and copied to the NZ Cancer Registry.
How can I see completed reports?
Enter the patient’s NHI number, or the report’s accession number, in the search fields.
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Why is the plain text report set out like this?
Because reports are transmitted via HL7, more attractive formatting isn't possible – tabs,
typefaces, font sizes, are all lost in transmission. The arrangement is long, but intended to be
clear at a glance.
The new-lines, indents, and quote marks around text entered by pathologists are intended to
make it possible, at a later date, to parse the content back into atomic data, enabling more
comprehensive use of the data.
How do I get the structured report changed?
Pathologists who feel strongly about the content of the protocol should raise this with their
RCPA representatives. If you have a usability issue with the template, the please pass this on to
the Ministry by emailing: onlinehelpdesk@moh.govt.nz
How does the New Zealand Cancer Registry use the checklist?
It doesn’t – not directly. The Assistant is a tool to help you produce your reports, following the
RCPA protocol to achieve complete, consistent results. The Assistant doesn’t have the
permanent, verified report.
Your lab system has the entire report, reviewed as usual. This is the ‘one source of truth’.
The finished report is sent by your lab system to requesting clinicians and copied to NZCR, as
usual. The NZCR team read the HL7 reports in a nicely-presented PDF view.
How does the Assistant store draft and completed reports?
In an XML database, on secure servers at the Ministry of Health.
Can I query reports for my laboratory?
Yes but only through your laboratory information system, not with the Structured Report
Assistant.
Help! My report says ‘Error on page’ and I can’t see the plain text.
The most likely reason for this is an unsupported browser, such as Internet Explorer 7. Use
Internet Explorer 8 or above, or preferably Firefox or Chrome if you can.
If you use Internet Explorer, make sure you use it directly – sometimes a link in your email
message may start an earlier version of IE.
How can I tell what version of Internet Explorer I have?
Go to Google, and type ‘What version of Internet Explorer’. The first answer should tell you
your Windows and IE versions.
If you need to report a problem, be sure to include this information.
The Assistant doesn’t work on IE 7 (and Microsoft don’t support this browser any more - it is a
security risk).
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Why does my browser say ‘There is a problem with this website’s security
certificate’?
HealthLink provides the security certificate for the Health Network (Connected Health).
Browsers don’t automatically install this. You or the lab IT manager may need to install it in the
browser you’re using.
From http://ca.healthlink.net/cacerts/ , choose
New Zealand Health CA, Root Key:
click the file NZHealthCA.cer, open it, and follow the instructions to Trust this CA to identify
web sites. Browsers vary, but it could mean accepting defaults and clicking Next, then Finish
until you see ‘The import was successful.’
To check that it was successfully installed, browse to https://nzcr.moh.health.nz/, click the
padlock or logo on the address bar (just before the https), and click View certificates >
Certificate information > Certification path. You should see this information:
What if I have another technical problem?
Contact the Helpdesk on 0800 505125 or email onlinehelpdesk@moh.govt.nz
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