Page tree
Skip to end of metadata
Go to start of metadata

Short Description

Cancer Electronic Pathology Reporting & IHE SDC/eCC on FHIR

Long Description

This project will use FHIR to support electronic health data exchange of cancer pathology information between a hospital or facility-based laboratory information system (LIS) and hospital or facility-based electronic health record (EHR) system. The goal of this project is to create one FHIR implementation guide (US Realm) that will be based on NAACCR Standards for Cancer Registries Volume V, Laboratory Electronic Reporting Pathology Version 5, May 2020 (Revised 2020). We will be aligning with the IHE SDC/eCC on FHIR IG and their testing efforts.  

This IG uses the FHIR message bundle paradigm and profile data from NAACCR Volume 5, including MessageHeader, DiagnosticReports, and Specimen. It is based on US Core profiles where possible, binding to terminologies such as SNOMED CT and the North American Association of Central Cancer Registries Volume II, Data Standards & Data Dictionary. It will also include CAP eCC Protocol CKey Identifier to SNOMED translation.  

We will be testing two implementation guides in tandem to ensure alignment, as well as to ensure our bundle can be included in the MedMorph Central Cancer Registry Reporting IG


Testing alignment between three implementation guides.

Submitting Work Group/Project/Accelerator/Affiliate/Implementer Group  

Orders & Observations

Track Lead(s)

Ruby Nash, Alex Goel

Track Lead Email(s) 

Related Tracks


FHIR Version


Specification(s) this track uses

Artifacts of focus

ServiceRequest, DiagnosticReport, Bundle, Encounter, PlanDefinition

Expected participants

Zulip stream

Track Kick Off Call

April 20, 2022 at 10:00 am ET

Track Details

System roles:

  • EHR (order from clinician/specialist)
  • Laboratory Information System (LIS) / Integration Engine
  • Cancer Registries


  • Clinician orders pathological analysis of specimen
  • Triggers specimen collection procedure
  • Specimen sent to lab
  • Specimen sectioned, analyzed
  • Results are collected, prepared outbound to registry or EHR
  • Systems receive the results


Previously we tested a path lab generating a completed synoptic report (through the SDC form filler) and tested turning that into FHIR observations and then wrapping it in a FHIR Bundle.

The bundle included Observations, Patient, DiagnosticReport, and MessageHeader.

Since those were tested last time, we are going to test the new pieces of the guide - which include the Order of the collection of the Specimen, the collection of the Specimen itself (process and procedure), and the ordering of the path lab analysis.

Finally, we plan to test this a lab system producing the results of these analysis and send it outbound either to an EHR or to a central registry via collection Bundle.

Success Criteria:  

  • Able to create and submit bundle to test Cancer Registry endpoints in conformance with the profiles defined in both IGs.

Bonus point:

  • Automatically trigger creation of the report with the PlanDefinition
  • EHR to EHR data transmission


Security and Privacy Considerations: