FHIR Standard-Based Oncology Data Model for Cancer Screening: Design and Implementation Study
Manisha Mantri1, Sayali Satokar1, Pritam Tambe1
1Centre for Development of Advanced Computing (C-DAC), India, Pune, India.
JMIR Cancer
|December 2, 2025
Summary
This study introduces a Fast Healthcare Interoperability Resources (FHIR)-based oncology data model (ODM) for improved cancer screening and risk assessment data exchange. The model enhances interoperability across the cancer care continuum, supporting early detection and management.
Area of Science:
- Health Informatics
- Oncology
- Digital Health
Background:
- Cancer remains a leading global cause of mortality, necessitating early detection and risk assessment for improved patient outcomes.
- Challenges in oncology data interoperability hinder effective cancer care delivery and research.
- Existing data systems struggle to integrate diverse oncology data, including clinical, genetic, and imaging information.
Purpose of the Study:
- To develop and validate a Fast Healthcare Interoperability Resources (FHIR)-based oncology data model (ODM) for structured cancer data capture and exchange.
- To focus on screening and risk assessment for breast, cervical, esophageal, lung, and oral cancers within an Indian pilot project.
- To enhance data interoperability across all stages of cancer care.
Main Methods:
- Developed an ODM incorporating 5 patient journey phases: encounter, risk assessment, clinical investigation, treatment, and outcome.
- Utilized FHIR Revision 4 standard, creating custom FHIR profiles and mapping terminology to SNOMED CT, LOINC, and ICD-10.
- Employed FHIR Shorthand (SUSHI) and IG Publisher for implementation guide creation, followed by technical, clinical, and usability validation.
Main Results:
- The FHIR-based ODM enhances interoperability across the cancer care continuum, from screening to treatment.
- The implementation guide includes 25 oncology-specific FHIR profiles and 50 standardized value sets, ensuring semantic and syntactic interoperability.
- Validated FHIR conformance, terminology binding, and usability of screening questionnaires, demonstrating practical application in clinical and community settings.
Conclusions:
- The FHIR-based ODM provides a unified framework for structured, interoperable cancer data exchange, crucial for screening and risk assessment.
- This initiative represents a significant step in applying FHIR standards to oncology data in India.
- Integration with national digital health systems is recommended for consistent data sharing and informing cancer policy and precision oncology.
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