CLINIAL Inc. (Shibuya-ku, Tokyo; CEO: Takaaki Mizuno) presented “A study on the item-level implementation of HL7 FHIR mCODE for inter-institutional collaboration in oncology” at the 44th Joint Conference on Medical Informatics (25th Annual Conference of the Japan Association for Medical Informatics), as a result of its joint research with the National Cancer Center Japan (Chuo-ku, Tokyo; hereafter “the National Cancer Center”).
This study examined how information that exists only in referral letters — such as treatment history at a previous hospital — can be standardized and reused. The work targeted an integrated database operated at an acute-care, cancer-specialty hospital (a foundation that aggregates text data from electronic health records and departmental systems). While the format for referral letters became an HL7 FHIR–compliant standard in 2022, a challenge remains: disease status and treatment history are not yet captured at a granularity that allows immediate secondary use.
We therefore classified the items in mCODE (minimal Common Oncology Data Elements, Version 4.0.0-ballot), the international standard for oncology, according to whether they were needed for clinical or for observational-research purposes, and evaluated how far the hospital’s integrated database could automatically satisfy them. Of the roughly 3,400 items set from clinical data across mCODE’s 6 theme groups and 65 profiles, 29.4% of the 1,076 items required for observational research and 29.1% of the 1,106 items required for clinical purposes could be immediately extracted from the integrated database. By contrast, groups such as Outcomes and Genomics showed low coverage — consistent with the reality that this information is scattered across electronic-health-record notes and PDF test reports.
Several clinicians also assessed the mCODE item framework itself as useful as an information structure for oncology. The findings suggest the need to realize inter-institutional sharing of mCODE/FHIR-compliant cancer treatment-history data going forward, through structuring electronic health records and revising report formats.
Building on the knowledge gained from this joint research, CLINIAL will further strengthen its collaboration with the National Cancer Center and other medical institutions, and work to build a data foundation that supports the standardization of cancer-care information and inter-institutional collaboration.
(Reference)
A study on the item-level implementation of HL7 FHIR mCODE for inter-institutional collaboration in oncology / 44th Joint Conference on Medical Informatics (25th Annual Conference of the Japan Association for Medical Informatics)
https://confit.atlas.jp/guide/organizer/jcmi/jcmi2024/subject/2-G-5-02/search;jsessionid=F32F3A886AD6932B14C937800A1DB261