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Problem and Target Outcome

Problem:

The complexity of cancer care increases with each year with new drug regimens and tumor genomicscontinues to increase, with new drugs approved and biomarkers discovered each year. Oncologists need decision support with access to up-to-date, evidence-based information to provide the best care for patients. This combined with rising healthcare costs associated with expensive cancer therapies has led to the rapid growth uptake in use of oncology clinical pathways, though it is cumbersome to maintain and share the pathways.  

Target Outcome:

mCODE and other clinical or administrative data from the EHR provide input to mCODE enabled, computable oncology clinical pathways that are aligned with the HL7 FHIR Clinical Guidelines and mCODE implementation guides.  

Standards based pathway definitions enable automated maintenance as well as sharing of definitions across institutions.


OCP Details

ActorOncologist
Description

An Oncology Clinical Pathway (OCP):  detailed decision tree protocol for selection of treatment options by oncologists, primarily focused on anticancer drug regimens for specific patient populations, including type, stage, and molecular subtype of disease.

Trigger

Oncologist launches pathway Smart-on-FHIR application.

Preconditions
  • The EHR system supports FHIR RESTful API and the integration of SMART-on-FHIR applications.
  • The EHR system can consume and produce valid FHIR resources.
  • The pathways content must come from recognized sources, such as academic medical centers or pathway vendors.
Postconditions

The oncologist accepts the treatment recommendation
OR
The oncologist declines the treatment recommendation, gives the rationale, and suggests alternatives.

Extensions

Pathways contain oncology and other clinical data elements that are not in mCODE for branch navigation.  These need to be modeled into CodeX elements to be used in pathway navigation.

Assumptions
  • The oncologist can enter pathway data elements via EHR forms or other means of structured documentation.
  • The pathways application can access the pathway data elements for navigation.
Scope

This use case covers the use of the pathways application to reach a treatment option.  Prior authorization is out of scope. 

Notes





Conference Call Information

Important Dates

EventDate/Time
First demo of Camino to UPenn22 January 2020
First demo of Camino to UCSF30 January 2020



Use Case Team

RoleNameOrganizationEmail
Domain LeadJim O'ConnorThe MITRE Corporation

joconnor@mitre.org

Technical LeadDylan HallThe MITRE Corporation

dehall@mitre.org

Chief EngineerRob DingwellThe MITRE Corporation

bobd@mitre.org