Development, implementation, and initial evaluation of a foundational open interoperability standard for oncology...

Area of Science:

• Health Informatics
• Oncology
• Clinical Data Standards

Background:

• Effective communication and care coordination are critical throughout the cancer journey.
• Existing health information exchange standards require oncology-specific adaptations.
• Early-stage breast cancer was selected as the initial use case for developing a new standard.

Purpose of the Study:

• To develop and evaluate a foundational oncology-specific standard for care communication and coordination.
• To create an implementation guide compatible with the Health Level Seven (HL7) Consolidated Clinical Document Architecture (C-CDA).
• To establish a standard for the transmission of clinical oncology treatment plans and summaries.

Main Methods:

• Developed an implementation guide aligned with the HL7 C-CDA framework.
• Balloted the guide through the HL7 process.
• Implemented the standard by the Health Story Project and the Athena Breast Health Network.

Main Results:

• The HL7 Implementation Guide for CDA, Release 2: Clinical Oncology Treatment Plan and Summary (eCOTPS) was published as a Draft Standard for Trial Use (DSTU).
• Successful implementation of eCOTPS was demonstrated in a clinical vignette at HIMSS 2014.
• Identified needs for additional CDA templates and addressed data element mapping challenges during implementation.

Conclusions:

• eCOTPS is the first oncology-specific CDA standard to achieve HL7 DSTU status.
• Early implementation confirmed vendor-agnostic transmission of oncology data.
• The standard's modularity allows for expansion to other cancer subtypes, enhancing care coordination for all stakeholders.