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The purpose of this CodeX Use Case Project Dashboard is to provide status updates for the most significant, overarching tasks associated with each Use Case. This dashboard will act to facilitate discussions regarding Use Case progress and performance for key tasks. CodeX Use Cases projects are in one of 3 stages:

  • Use Case Projects in Active Community Execution are projects where models, mCODE-based FHIR IGs, implementations and pilots are currently under development, led by CodeX members.
  • Use Cases in Active Community Planning are, as the name implies, being planned with Members - Identifying necessary stakeholders, objectives, deliverables, measures of success and schedules for fast-moving phases.
  • Use Cases are in the Discovery are ideas that have been proposed for future consideration, with small group, concept-shaping discussions are underway.

Contact Steve Bratt to learn more about any of the Use Cases below. All are welcome to join the CodeX/mCODE Community of Practice.

Use Cases and Objectives

Key Work Underway

Key Accomplishments

Active Community Execution



mCODE++ Extraction

Software to enable existing EHRs and other systems to share cancer patient data conformant to the mCODE FHIR IG, to support a variety of use cases.

ON TRACK Implementing Extraction framework to support the ICAREdata project within the EHR Endpoints for Cancer Clinical Trials use case. 

EHR Endpoints for Cancer Clinical Trials (ICAREdata)

Collect research-quality mCODE-based data in and share from EHRs to increase the value of real-world data for clinical trials, and reduce and potentially eliminate manual and/or duplicate data entry into case report forms. 

ON TRACK ICAREdata Phase 2 - 5 activated embedded trials and 11+ health systems committed. Approved companion study protocol to partner with ongoing clinical trials.

ON TRACK ICAREdata Adverse Event Reporting - Drafted initial AE model in draft CTCAE IG and documented AE clinical workflow.

COMPLETE Draft FHIR IG 

COMPLETE Phase 1 – Demonstrated successful collection of Cancer Disease Status as a structured phrase in patient clinical note


Integrated Trial Matching for Cancer Patients and Providers 

Leverage mCODE-based data standards and open APIs that enable interoperable, scalable, and accessible clinical trial matching services to improve the ability for patients to find clinical trials for which they may be eligible. 

ON TRACK Phase 1A – integration with Cancer Insights, recruiting patients to join application and test capability, evaluating the optimized patient data elements

ON TRACK Phase 1B – use of retrospective patient data from UTSW and Massive Bio, evaluating the optimized patient data elements 

COMPLETE Draft FHIR IG  

COMPLETE Phase 0 Pilot using synthetic data to find trials via one matching services (Report)

COMPLETE Trial Matching PSS approved by HL7 BR&R Workgroup and TSC

Cancer Registry Reporting

Enable reporting of mCODE-based cancer data from cancer center EHRs to registries that are aggregating data for different reasons, substantially reducing duplication and burden while increasing reporting speed and accuracy.

ON TRACK Phase 0 - Collect requirements and build technical architecture needed for pilot activity - conveying essential patient data to registries in a timely/low burden way

ON TRACK Phase 0 - Health system(s) commitment for implementation, pilot activity start

COMPLETE Phase 0 - Determine patient data to use

COMPLETE Phase 0 - Determine state registry endpoint for pilot

DEFERRED Drafting PSS in FHIR IG Publishing Process - decided to publish under MedMorph as Content IG, separate PSS as needed

Radiation Therapy Treatment Data for Cancer

Leverage mCODE and extensions to enable sharing of critical radiation therapy treatment data for care coordination or data reuse (research, quality measurement, payer-required reporting).

ON TRACK HL7 Work Groups are considering the opportunity to sponsor the RTTD Project Proposal that was submitted to HL7 

ON TRACK IHE-RO Exchange of Radiotherapy Summaries (XRTS) technical framework documentation includes the mCODE radiotherapy profiles and value sets defined in mCODE STU 2

  • Varian and RaySearch are preparing to implement the XRTS framework

ON TRACK Michigan and the VA are preparing preliminary steps to implement the mCODE profiles for pilot activities. Oncoclínicas, University of Pennsylvania and Ohio State are also interested in piloting

COMPLETE Draft FHIR RTTD IG

COMPLETE RTTD GitHub Repository 

COMPLETE Updated existing radiation therapy concepts and modeled new extensions for mCODE STU 2




Discovery



Oncology Clinical Pathways (on hold)

Enable clinicians to use an oncology clinical pathway applications that accurately navigates to recommended treatments using mCODE-based data from the EHR.



Prior Authorization in Oncology

Facilitate sharing of mCODE-based clinical data between providers and payers to reduce burden and speed authorization or requests for more information.

COMPLETE  Develop an end-to-end proof of concept with full prior authorization in conformance with Da Vinci standards

DELAYED  The challenge has been getting one or more payers that want to explore and develop FHIR-based information exchange.  We did have success with United Healthcare joining CodeX, but they serve as expert collaborators.  Various outreach activities attracted several new organizations we are currenting engaging. 


COMPLETE  The proof of concept features the Da Vinci prior authorization information exchange with two synthetic cancer patients who have mCODE elements.  The exchange shows extraction of mCODE from the EHR via a SMART-on-FHIR application.  This data pre-populate the FHIR questionnaires used in interaction between provider and payer.

Genomics Data Sharing

A more standard way of sharing of genomic data among clinical providers - using mCODE and supplemental elements - could improve care coordination and other uses, such as clinical trial matching.  Experts are currently exploring ideas for and interest in a specific use case in this important area.




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