Radiation therapy treatment details – critical for care coordination – are typically available in radiation oncology electronic health record (EHR) modules, commonly recorded as free text notes, and manually entered into radiation therapy (RT) treatment summary documents. This may result in high clinician burden, transcription errors, and reflect lack of standardization in recording, generating, and sharing patients’ RT treatment summary reports. The summary documents are not available to other information systems and typically require manual querying of information to form a summary report. The summary information requires access to the radiation oncology information system which is not typically integrated into a “main” EHR.

The CodeX Radiation Therapy Treatment Data (RTTD) project will develop, test, and deploy FHIR-based, open data standards and open application programming interfaces (APIs) that enable interoperable, multi-purpose exchange of RT treatment summary data for care coordination and data reuse, such as quality management, research, and payer-required reporting. The project’s initial goal is to enable radiation oncology information systems to generate RT treatment summaries (e.g., end-of-treatment and in-progress summaries) using structured data elements that can be exchanged using FHIR. The project is working to include prescription details to support the RT treatment summaries, as well.

A CodeX Radiation Therapy Treatment Data Implementation Guide is being drafted, adding a layer of radiotherapy specific FHIR content on the foundation of mCODE STU 2 (Minimal Common Oncology Data Elements). 

The project team is working through standards development for the radiotherapy FHIR profiles and has started developing a draft Radiation Therapy Implementation Guide through HL7. The RTTD team has been engaged with radiation oncology information system vendors and health sites to begin considering implementation of these radiotherapy profiles in FHIR. Implementers include (but are not limited to): Varian, RaySearch, Elekta, University of Michigan, Veterans Health Administration, and McGill University.