Cancer E-Path Reporting - Connectathon Track Kick-Off-20220914_080807-Meeting Recording.mp4

Short Description

Cancer Electronic Pathology Reporting & IHE SDC/eCC on FHIR

Long Description

This project will use FHIR to support structured electronic 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 to a Central Cancer Registry (CCR). The goal of this project is to create one FHIR implementation guide (US Realm) that will compliment the currently accepted and widely implemented V2 and 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 these two implementation guides in tandem to ensure alignment, as well as implementing an app to query an EHR, compile pathology reporting data, and send it to a registry.


Continued testing of alignment between IHE SDC/eCCs on FHIR and Cancer E-Pathology Reporting IGs, as well as use of a backend services app to facilitate reporting to a registry.
Track Prerequisites

Understanding of Message Bundles, Observations, & DiagnosticReports required

Familiarity with MedMorph ( a plus

Track Lead(s)

Ruby Nash, Alex Goel

Track Lead Email(s) 

Specification Information

Call for participants

EHR Vendors

Laboratory Information Systems

Cancer Registries

Backend Service Apps

Zulip stream

Track Kick off Call

September 14 at 10:00 am ET


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Clinical Input Required?
Related Tracks?

Testing Scenario:

System roles:

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


  • 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 simulated 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. We tested submitting this bundle to an EHR and/or CCR. We also tested 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, as well as 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.

We will be further refining this testing in September, as well as testing a more complex example of Specimen collection and sending to EHR or central registry. We also will be re-testing the use of a Backend Services App to query an EHR, compile a pathology report via our bundling, and pushing it to a cancer registry.

Success Criteria:  

  • Able to create and submit bundle directly from LIS to Cancer Registry endpoints in conformance with the profiles defined in both IGs.
  • Successful use of a BSA to collect Cancer path data and send to a cancer registry.
  • Successful bundling of complex Specimen collection from an EHR and sending to a registry.

Bonus point:

  • Successful, automatic trigger creation of the report with the PlanDefinition
  • Autmatic triggering criteria for creation and exchange for each of the "success criteria" defined above.
  • EHR to EHR data transmission


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