Travis Osterman, DO, MS, director of Cancer Clinical Cancer Informatics at Vanderbilt-Ingram Cancer Center, is leading an integral component of the Minimal Common Data Elements (mCODE) initiative, establishing common data standards for oncology clinicians and researchers.
Making electronic health records compatible between hospitals and research entities has been a longtime goal. Still, progress has been hampered because these institutions utilize different data infrastructures, such as Epic, Cerner and Allscripts.
Built on top of the Fast Healthcare Interoperability Resources (FHIR) standard, mCODE will be a universal language system in the cancer space that will be compatible with these infrastructures offered by different vendors. It enables a clinician to analyze medical records across the lifetime of a cancer patient or a researcher to mine de-identified patient cohorts.
“mCODE is like a set of Lego blocks; you can build with it what you want,” said Osterman, a thoracic oncologist and assistant professor of Biomedical Informatics and Medicine and chair of the mCODE Technology Review Group.
For instance, mCODE will be implemented at Vanderbilt-Ingram and other cancer centers to expedite clinical trial data collection.
“With clinical trials, researcher nurses have to file a lot of extra information about patients that is part of the trial,” Osterman said. “We are trying to get that granular data worked into routine care. Similarly, we are working to integrate clinical trial matching. We want to figure out the best way to match patients with the best trials for them. We have a group specifically working on that. Only about 5% of patients with cancer participate in clinical trials, while many of our guidelines state that clinical trials should at least be considered for all cancer patients.”
The mCODE data standard began as an American Society of Clinical Oncology initiative. It has grown through partnerships with similar organizations internationally as well as the Alliance for Clinical Trials in Oncology Foundation and the American Society for Radiation Oncology.
“This is exciting,” Osterman said. “I’ve never been part of a project that has had the support of so many professional societies and governmental agencies. This is getting a lot of visibility. A major hurdle has been that Epic Systems, the largest electronic health record vendor in the world, has been working very closely with us to implement mCODE, so this functionality is being built directly into the largest EHR vendor. There is a real groundswell of support for this because it’s the right thing to do.”
The mCODE system will allow Vanderbilt to showcase its expertise in genomics.
“We’ve put tremendous effort at Vanderbilt to be a leader in structuring our genomic data,” Osterman said. “In the cancer space, these genomic data are a real interest for researchers in clinical trial matching. Our EHR currently has the sixth most structured somatic data in the country, and we will be No. 1 by next quarter. That’s exciting, and we are planning to lead some projects in the genomics space for mCODE. Vanderbilt is well-positioned in the precision medicine and precision oncology space.”
