The binding of below data elements should be changed from required to extensible, such that in cases where mapping to SNOMED CT fails, the data still can be retained in mCODE defined extensions and we can avoid losing the data or using proprietary extensions in parallel.

Extension: TreatmentTerminationReason

Extension: ProcedureIntent

Profile:  RadiotherapyCourseSummary , element Procedure.bodySite

Extension: RadiotherapyModalityAndTechnique element modality

Extension: RadiotherapyModalityAndTechnique element technique

Profile: RadiotherapyVolume BodyStructure.location

Implementation and testing in three IHE-RO workshops 2022, 2023 with multiple vendors has shown that practical radiotherapy systems cannot map all existing data to the required ValueSets of mCODE. Some values can be mapped and generally mCODE Radiotherapy profiles were successfully used. But in some cases the mapping to SOMED CT is not reliably possible, and changing the software at customer sites to capture the data differently can take many years. FHIR interfaces can be added much quicker, but may need to be more flexible to allow imperfectly encoded data. To pass mCODE validation, systems would currently have to completely drop these data elements or use proprietary extensions in parallel. Vendors in IHE-RO discussed and agreed to rather keep data in a form that can be interpreted by humans or a subset of systems that loosing the data.