Objective: Develop and evaluate a foundational oncology-specific standard for communication and coordination of care throughout the cancer... » More

Objective: Develop and evaluate a foundational oncology-specific standard for communication and coordination of care throughout the cancer journey, with early-stage breast cancer as the use case.

Materials and Methods: Due to broad uptake of the HL7 Consolidated Clinical Document Architecture (C-CDA) by health information exchanges and large provider organizations, we developed an implementation guide (IG) in congruence with C-CDA. The resultant product was balloted through the HL7 process and subsequently implemented by two groups: the Health Story Project (Health Story) and the Athena Breast Health Network (Athena).

Results: The HL7 Implementation Guide for CDA, Release 2®: Clinical Oncology Treatment Plan and Summary, DSTU Release 1 (eCOTPS) was successfully balloted and published as a Draft Standard for Trial Use in October 2013. Health Story successfully implemented the eCOTPS atHIMSS 2014 in a clinical vignette. During their evaluation and implementation, Athena identified two practical issues: 1) the need for additional CDA templates specific to their use case and 2) the many-to-many mapping of Athena-defined data elements to eCOTPS.

Discussion: Early implementation of eCOTPS has demonstrated successful vendor-agnostictransmission of oncology-specific data. The modularity enabled by the C-CDA framework makes expansion of the eCOTPS to include other cancer subtypes relatively straightforward. Lessons learned during the process will strengthen future versions of the standard.

Conclusion: eCOTPS is the first oncology-specific CDA standard to achieve HL7 DSTU status. Oncology standards will improve care throughout the cancer journey by allowing efficient transmission of reliable, meaningful, and up-to-date clinical data between the many involved stakeholders.

Edward P. Ambinder MD, FASCO is an independently practicing oncologist affiliated with the Tisch Cancer Institute at the Icahn School of Medicine at Mount Sinai. He has been involved in health information technology efforts for many years, including some of the foundational work of creating the caDSR clinical data element repository. He is the current Chair of the American Society of Clinical Oncology (ASCO)'s Data Standards and Interoperability Taskforce, which was responsible for creating the eCOTPS DSTU R1 and R2. He is also the Director of Medical Symposia at The Chemotherapy Foundation.

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