By Kim Ball, Senior Consultant

Now is the time to engage with HL7 CodeX and bring your expertise to bear on improving data exchange in the complex space of oncology. The CodeX (Common Oncology Data Elements eXtensions) initiative is a member-driven HL7 FHIR Accelerator aimed at building a community to accelerate interoperable data modeling and applications that lead to step-change improvements in cancer patient care and research. CodeX prioritizes urgent needs across the oncology ecosystem, such as strengthening clinical trial matching for patients and providers and improving data collection and sharing for cancer registries and radiation therapy treatment. For more on CodeX use cases visit this link.

CodeX is inviting a wide range of stakeholders to participate in a June 3 listening session (from 1-2:30 pm ET), to identify and flesh out problems in the current state of provider-payer oncology data exchange. Insights and input are being sought from providers, payers, patients, and vendors to develop increased, in-depth understanding of the pain points and barriers involved in provider-payer data exchange in the oncology ecosystem and where standardization with HL7’s FHIR (Fast Interoperable Healthcare Resources) standard can add the most value. The session will also delve into how the minimal Common Oncology Data Elements (mCODE) provide opportunities to help automate oncology care data exchange. (Click here to register).

Why is this focus on interoperability in oncology important now? The healthcare industry as a whole is moving forward with computerization of provider-payer data exchange. However, this may not be as straightforward for oncology as in other use cases. Oncology care is incredibly complex and expensive, often involving many sites of care. The annual costs of cancer care are expected to soar, from $157 billion to more than $245 billion in 2030. The prevalence of cancer is expected to increase due to the growth and aging of the U.S. population. Further, patient records do not always travel with them through the continuum of care, making it difficult for providers and payers to exchange clinical, coverage and payment information.  While improved electronic exchange of clinical and administrative data is evolving, oncology care is fraught with administration burden and interoperability challenges. These are also key areas of focus by the federal government through the Office of the National Coordinator for Health Information Technology (ONC).

What can attendees of the June 3 listening session expect? The MITRE Corporation and Point-of-Care Partners (POCP) are managing the CodeX project and representatives will be moderating the June 3 listening session. To get a better picture of the issues, they will be eliciting stakeholder input on questions such as:  

• What are your top priorities for investing in payer-provider data exchange for greater interoperability within the oncology ecosystem? 
• How are you supporting Prior Authorizations in oncology today and what are the biggest pain points? (e.g., workflow, data standardization, manual re-entry, lack of consistent process, and available tools) 
• At what point in time in the workflow does the provider have an opportunity to get Prior Authorization requirements?  There’s been discussion about the desire to look holistically at an entire care plan/pathway for rior Authorization submission/approval (rather than each service/med request) in a standard multi-payer process way (i.e., not individual portal approach). Where do payers fall along that journey?

Other ways to participate. Can’t make the June 3 meeting but want to get involved? There are other ways to participate. For example, the May 28, 2021, CodeX Community of Practice meeting will feature Dr. James Chen from Ohio State University Medical Center discussing the challenges around standardized/structured genomics data, how mCODE is working to improve these challenges, and an early introduction to the CodeX genomics work group. Register here.

You also can keep up to date with CodeX activities on the LinkedIn page. 

As always, please feel free to reach out to me at kim.ball@pocp.com.