Data Standards
Data standards are crucial for seamless communication and interoperability among different systems, which is made more important by the multidisciplinary nature of cancer care. Data standards provide consistent and accurate information exchange, improving patient care, reducing errors and enhancing research capabilities. Standardized data facilitates efficient decision making, enhances data security, and promotes innovation in health care technology, ultimately benefiting both providers and patients.
In 2019, ASTRO developed a Minimum Data Elements paper to define the core radiation therapy data elements that must be entered in the oncology information system for seamless exchange between electronic systems. The paper was intended to provide a starting place for standardizing radiation oncology data elements and as an opportunity to educate those outside of the field about what data are necessary to capture and transfer.
During the development process, ASTRO learned about the minimum common oncology data elements standard, or mCODE. mCODE is an initiative intended to increase interoperability by assembling a core set of structured data elements for oncology electronic health records (EHRs) using the HL7 FHIR data standard. ASTRO joined the mCODE Executive Council in 2019, alongside the American Society of Clinical Oncology, the Alliance for Clinical Trials in Oncology, the FDA and others, and has been integral in the activities and growth of the initiative.
ASTRO has since led the largest expansion of the mCODE standard, which is being adopted by health systems, EHR vendors, CMS and other entities. The initial standard, introduced in 2019, included only three treatment-related data elements: procedure, treatment intent and body site. The radiation oncology-specific section significantly increased, as shown below, to include modalities, techniques, volume-based treatment site, dose, etc.
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Much of the development work was completed through the CodeX initiative in collaboration with the American Association for Physicists in Medicine, Varian, Epic and Elekta. CodeX is an HL7 FHIR Accelerator focused on specialty-specific data, including cancer, cardiology and genomics. ASTRO has been engaged with CodeX since 2020 and is active in several use cases including:
The complete FHIR Implementation Guides are available with additional detail for mCODE and Radiation Therapy.
Contact Randi Kudner, ASTRO staff, with any questions.
