Problem and Target Outcome

Problem:

The complexity of cancer care continues 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 uptake in use of oncology clinical pathways, though it is cumbersome to maintain and share the pathways.

Target Outcome:

Computable oncology pathways based on nationally accepted guidelines, and the HL7 FHIR Clinical Guidelines and mCODE standards provide evidence based treatment recommendations to the oncologist.

OCP Details
Actor	Oncologist
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