At ECR 2025 (European Congress of Radiology), held in Vienna, Austria, “Evaluation of the compatibility of HL7 FHIR mCODE with the data set for healthcare information exchange (HIE) of radiotherapy history in Japan and the United States” was presented as a result of joint research by CLINIAL Inc. (Shibuya-ku, Tokyo; CEO: Takaaki Mizuno) and the National Cancer Center Japan (Chuo-ku, Tokyo; hereafter “the National Cancer Center”).
This study aimed to build a data-collaboration foundation for sharing cancer radiotherapy history across institutions and borders, and verified how far mCODE (minimal Common Oncology Data Elements) and HL7 FHIR — the international standards for oncology — can be applied to radiotherapy data in Japan and the United States. Targeting an integrated database that aggregates data from roughly 50 systems, including electronic health records and departmental systems at a tertiary cancer-specialty hospital, we evaluated how well mCODE items are covered for each use case: research, clinical trials, and routine clinical care.
As a result, of the roughly 3,400 mCODE elements, 292 of the 1,076 items (29.4%) required for Clinical Research and 297 of the 1,106 items (29.1%) required for Clinical Practice could be extracted immediately from the integrated database. Furthermore, 90.1% of the standard items in JROD (Japanese Radiation Oncology Database) and 68.4% of the U.S. ARS Radiotherapy Summary were covered by mCODE, confirming that mCODE has high comprehensiveness for information exchange centered on radiotherapy history. On the other hand, information that depends on free-text — such as medical history and conference notes — proved difficult to connect directly to healthcare information exchange (HIE) in its raw form.
In conclusion, the study suggested that while healthcare information exchange (HIE) using mCODE can standardize and structure much of the essential information needed for cancer care, including radiotherapy history, additional approaches are effective for patient profiles and free-text information — such as combining existing FHIR resources or structuring text using large language models (LLMs).
Building on the knowledge gained from this joint research, CLINIAL will collaborate with the National Cancer Center and other medical institutions in Japan and abroad to advance the implementation of a foundation for standardizing cancer-care information and enabling inter-institutional collaboration using mCODE / HL7 FHIR.
(Reference)
EPOS™ - ECR 2025 / C-15047 | Evaluation of the compatibility of HL7 FHIR mCODE with the data set for healthcare information exchange (HIE) of radiotherapy history in Japan and the United States
https://epos.myesr.org/poster/esr/ecr2025/C-15047