Semantically Interoperable Oncology Information System - Oncology 4.0

Abstract

Realizing the possibilities of eHealth will depend on the capacity to share information across time and space. Multiple actors, systems, machines, and organizations must seamlessly and unambiguously communicate. Therefore, we created a semantically interoperable oncology information system (Oncology 4.0). The objective of the Oncology 4.0 project was to validate the technology framework for oncology information management. We developed a system around four loosely coupled modules: shared meta-thesaurus, dynamic form creator, Fast Healthcare Interoperability Resources (FHIR) RestFull Application Programming Interface, and semantic engine. To validate the technology, we have created a cohort of synthetic head and neck cancer patients. We have described a single patient with 1432 data points, which represents clinical, pathological, genomic, treatment, and workflow data. The data collection instruments, forms, documents, and interfaces were created while respecting the FHIR framework. We have assigned random values to each variable while respecting data from the literature (median and standard deviation for a continuous variable, frequencies of occurrence for categorical variables). To test the real-world scenario, we changed the document structure in 10% of the patient, we have exchange synthetic patient data with the radio-oncology treatment planning system (ROTPS), and we have exchange data with a pathology information system (PIS). We have successfully created 10.000 in-silico head and neck cancer patients. Every data point was accessible through the FHIR interface and defined within shared thesaurus entry. We have achieved bi-directional intra-institutional data exchange with ROTPS and inter-institutional data exchange with PIS. We were capable to dynamically change the content of the clinical documentation without endangering the underlying database model. We have overcome significant technical barriers and demonstrated semantical interoperability between disparate healthcare systems. Further steps will include solving problems on the political and functional interoperability level.