Background

The National Cancer Institute (NCI) Center for Biomedical Informatics and Information Technology (CBIIT), the American Society of Clinical Oncology (ASCO), and the National Community Cancer Centers Program (NCCCP) would like to invite your comments on the Clinical Oncology Requirements for the Electronic Health Record (CORE) project.

A document has been produced from this collaborative project in which NCI CBIIT, ASCO and NCCCP participants came together to identify the EHR needs of practicing oncologists. Clinical oncology involves many complex care processes unique in medicine, such as chemotherapy administration. Existing EHR solutions vary in their functional capabilities and until now there has been no detailed, consensus driven reference source of oncology requirements. Consequently, many oncologists are reluctant to commit to a system without the reassurance that a minimum standard has been met. Therefore, the CORE project sought to define the oncology-specific needs of the oncology specialty in an EHR solution so that we could then begin to work with vendors to support the adoption of these requirements.

The CORE project provides a clear understanding of the EHR functions needed to support oncologists in clinical practice, paving the way for adoption of oncology-specific products. The project consisted of three work groups:

• Functional Requirements Work Group - describing the required oncology specific EHR functions
• Data Elements Work Group - providing the structured data elements needed for oncology EHRs
• Interoperability and Security Standards Work Group - providing a common set of interoperability and security standards that will allow oncology-specific data to be shared between EHRs
  

These three work groups have met regularly to come to consensus on the detailed functionality, data elements, and interoperability standards for an oncology-specific EHR. The groups began meeting in the fall of 2008 and will finish their work in early fall 2009. Hundreds of volunteer hours have made the effort possible.

The CORE project comes at an opportune time, as the Certification Commission on Health Information Technology (CCHIT) plans to begin certifying oncology-specific EHRs in 2011. NCI and ASCO plan to extend their support to CCHIT in the development of the requirements for oncology EHR technology.

Moving forward, NCI plans to build a reference implementation of these requirements, in the form of an open-source EHR, which will be available by 2011. It will contain the basics that an oncologist would need to conduct care and exchange information, as defined in the CORE requirements. Note that the open source oncology EHR solution will not, however, provide the full-service support services, regular system upgrades and enhancements and additional features that the vendor community can more readily supply to the oncology specialty. We plan to work with the vendor community to inform this reference implementation in order to assure that it can be used by the commercial vendor sector in supporting their development needs in providing oncology-specific EHR solutions to their customer base.

Public Comment

We seek the input of all interested parties to make sure that the requirements meet the needs of both primary oncology EHR users as well as parallel practitioners who may be consumers of data from such an EHR.

Each functional requirement in the CORE document has an identification reference (on the left hand column of the document, labeled "ID"). To facilitate the compilation of comments, we ask that you use the identification reference provided, or reference the appropriate section of the document. If you prefer, you may type your comments directly into the CORE document and submit it to the e-mail address listed below. The deadline for receipt of comments is October 19, 2009.

Preliminary public comments will be compiled and released at the ASCO EHR Symposium in San Francisco, CA, October 6th & 7th. The CORE project will publish both a detailed specification package and an overview whitepaper at the symposium. The goal of our combined effort is to help shape oncology EHR development to best support the needs of the practicing oncologist and other providers of cancer care.