IHERO Electronic Patient Record

Interested Participants

If you're interested, please add your name and contact info.

• Colin Field, Medical Physicist
  • Cross Cancer Institute, Edmonton, AB, Canada
  • email: cfield@cancerboard.ab.ca
  • phone: 780-432-8625
• Mahmoud M. EL-GANTIRY,Radiation Oncologist,
  • National Cancer Institute – Cairo University, Kasr EL-Aini street, Kornish El-Nil, Fom El-Khalig, 11796, Cairo, Egypt.
  • Cellular Tel: +2-0101799845.
  • Fax: +202-23635083.
  • e-mail: melgantiry@yahoo.com
• Andrew Miller, Radiation Oncologist
  • Illawarra Cancer Care Centre, Wollongong, NSW 2500 Australia.
  • email: alexisandrew@gmail.com
  • phone: +61409654239

Links to Other Organizations working on this Task

• HIMMS
• ???

Required Data Elements

An overarching requirement is that the Knowledge Representation of data elements within the database structures defined match that of the oncological thought processes. In this way, clinical data be fragmented into a database storage schema and then re-constituted without loss of knowledge. This requirement calls for an EPR which has a strong diagnosis/time based approach to data that correctly indicates sequencing and the oncological reasons for events. This thinking is not present in some very widespread Oncology Information Systems (elaboration can be provided if required).

The present and unchanging process of patient management follows the following pattern: () > Intent > Modality Selection > Treatment Delivery > Outcome

Patient	Consultation	Intent	Modality Selection	Treatment Delivery	Outcome
Unique Identifier Demographics immutable characteristics birth parameters parents birth place birth date birth place birth gender mutable characteristics occupation residency affiliations	Diagnosis origin site code ontological description of anatomic extent image-based description of anatomic extent Stage disease extent code ontological description of anatomic extent image-based description of anatomic extent Prognosis/Risks parameters known to affect disease outcomes Physiology parameters not known to affect disease outcome Eligibility/Exclusion parameters that determine eligibility for treatment parameters that determine eligibility for trial inclusion	One of the following words can be assigned to describe the general oncological intent. This is similar to describing my intent in travel - to get from my home to the Empire State Building. It is not "by plane" because no plane leaves from my house or lands at the ESB (well, never again hopefully). It's the following modalities: neoadjuvant drive > neoadjuvant train > neoadjuvant walk > primary plane > adjuvant walk > adjuvant taxi > adjuvant walk. limited choices radical/curative palliative surveillance	This section results in the selection of a pair of terms - a modality with a descriptor, such as 'primary surgery', or "primary radiotherapy with concurrent chemotherapy" or "primary radiotherapy with neoadjuvant, concurrent and adjuvant hormone therapy" name of modality surgery radiotherapy chemotherapy hormone therapy biological therapy modality hierarchy palliative primary single determines timing neoadjuvant (before primary) concurrent (with primary) adjuvant (after primary)	This is a detail section which will vary for each modality, but provide the details of what was undertaken. surgery operation type operator pre-op R assessment post-op R assessment radiotherapy prescription plan treatment delivered chemotherapy regimen cycles delivered hormone therapy drug	On treatment Effects Acute Side effects Complications Disease Response Post Treatment Effects Late Effects Dysfunction Assessment Disease Status

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• Demographics
  • need a way to use demographics to produce a unique ID to produce anonymous records if transferred
• Diagnosis
  • utilizing a structure which is mapped (via UMLS)
    • presently
      • using ICD .... 9 (USA) 10 (AU, NZ, UK?)
      • predominantly for malignant diagnosis alone
      • already includes structured morphology nomenclature (e.g. SNOMED
    • FUTURE
      • include all benign diagnoses (these are likely to be be transferrable from other specialties and GPs)
      • expanded morphology descriptors that include immunohistochemical patterns, genetic changes
• Stage
  • utilizing a structure which is mapped (via UMLS)
    • presently we use AJCC/UICC
    • in the future
      • utilizing more specific anatomical definitions
        • derived from CT/MRI/PET anatomy (?DICOM-SR subset)
        • described in an Anatomical Ontology
• Intent of Oncological Plan
• Employed Modalities
• Modality Details