An interoperable HL7 document standard to improve the quality of cancer care across multiple locations.

Abstract

12 Background: Cancer care is by nature interdisciplinary and increasingly depends on seamless electronic transmission of clinical data. Health information exchange and semantic understanding are critical for improved outcomes, personalized medicine, comparative effectiveness research, and cost control. While there is a growing focus on this, sharing patient information remains difficult due to a lack of standardization and general incompatibility between electronic health record products. There is a need for well-designed, oncology-specific interoperability standards. Thus ASCO is developing standards to improve the quality and insight of cancer care. Methods: ASCO volunteers formed a Standards Work Group (Standards WG) in 2012, and ASCO engaged an independent consulting firm to perform the technical work. The Standards WG first developed an interoperable standard with broad application that would also be a foundation for future standards work. They adapted ASCO’s Breast Cancer Adjuvant Treatment Plan and Summary (Breast TPS), which was originally developed as a paper-based form. This adaptation required extensive work involving input from medical and surgical oncologists, ASCO staff, and the consultants. This preparatory work was vital to define and disambiguate clinical concepts. Some value sets in the original Breast TPS were replaced with National Cancer Institute value sets. Multiple oncology and standards stakeholders reviewed the draft to ensure accurate representation of the data and harmonization with related standards. Results: The standard was developed using the Health Level Seven International (HL7) Clinical Document Architecture, a widely used XML-based markup standard with national and international recognition. The draft Breast Cancer Adjuvant Treatment Plan and Summary Standard was successfully balloted through HL7 in May 2013 and will subsequently be published for trial use in late 2013. Conclusions: The Breast Cancer Adjuvant Treatment Plan and Summary Standard will improve quality by allowing providers to efficiently transmit clinical data with semantic meaning to health professionals, patients, quality improvement initiatives, and registries.