Biden, MITRE Cancer Moonshots Share a Common Path

MITRE’s oncology moonshot is supporting the Biden Cancer Moonshot in its efforts to end cancer as we know it. And our work is receiving attention, including a mention in a White House blog post: Improving Cancer Care Through Better Electronic Health Records: Voluntary Commitments and Call to Action.

Both moonshots are working to standardize patient data across electronic health record (EHR) systems, which will improve cancer treatment and monitoring, drive biomedical research, and support more-effective public health interventions. 

"When we originally launched the moonshot, the intent was to standardize EHR data at the point of care to help improve treatment. We had the vision for sharing, analyzing, and learning from what the data reflect: the experiences of millions of cancer patients," says Andre Quina, principal investigator of the MITRE oncology moonshot. 

"We’ve heard many times from the cancer community that this research is enabling outcomes that would not have been possible without the oncology data standard we created and the approach we developed to share it freely with government, providers, patients, vendors, insurers, life sciences, and researchers."

Today, the Biden-Harris Administration’s Cancer Moonshot uses mCODE (minimal Common Oncology Data Elements®) in several initiatives. These include U.S. Core Data for Interoperability Plus Cancer (USCDI+), a set of key cancer-related data elements that can be shared from a person’s electronic health record, and the Enhancing Oncology Model (EOM), a payment model developed by the Centers for Medicare and Medicaid Services (CMS) to drive transformation and improve care coordination in oncology. 

CONNECTING ALL STAKEHOLDERS

Initially, the MITRE moonshot team built on MITRE’s years of health IT system research. The goal was to ensure interoperability across EHR systems so the valuable data collected as part of research studies, and during patient care, would be used to advance cancer innovations and treatment. Working with partners such as the American Society of Clinical Oncology, we developed mCODE.

"We knew for sure that an enduring solution had to work for all oncology stakeholders—everyone has to benefit," adds Quina. "In addition to creating enabling technology to support interoperable systems, the entire moonshot team has worked for five years to educate and engage stakeholder groups. 

"We knew we’d reached a tipping point last year when users around the world began implementing mCODE on their own. Today, a vibrant mCODE community, known as CodeX, develops and leads new use cases to expand mCODE’s use."

To drive the implementation of mCODE across stakeholder groups, MITRE led the development of CodeX™ as a Health Level Seven® Fast Healthcare Interoperability Resources® (FHIR) Accelerator. As a member-driven community, CodeX focuses on advancing clinical specialty data exchange standards so patients can have the care and research journeys they deserve. Its rapidly growing membership is pursuing use-case pilots that span research, patient care management, quality measurement, prior authorization, and more.

"CodeX now stands on its own and is fulfilling our vision of a community that will ensure mCODE continues to evolve and meet the needs of stakeholders," says Su Chen, M.D., clinical lead of MITRE’s oncology moonshot and chair of the CodeX steering committee.

The Biden-Harris Administration is also bringing together the community of cancer stakeholders—including healthcare providers, patients, insurers, vendors, government agencies, and researchers—to support USCDI+ Cancer and EOM. 

"None of this would be possible without the work MITRE and our partners have done on mCODE," adds Quina. "We’ve been able to anticipate the needs of our federal agencies and we’re now working directly with many of them."

These include the Office of the National Coordinator for Health IT, the National Cancer Institute, CMS, the Centers for Disease Control and Prevention, and the U.S. Food and Drug Administration.

WHAT’S NEXT?

MITRE’s team—including many new partners—is sharing the mCODE approach with new communities in cardiology and genomics. 

"We’ve been very successful with our approach to developing data standards and enabling technology and launching them through community-driven use cases," adds Quina. "We're now taking our best practices and lessons learned and documenting this approach in a playbook that other groups can use to advance FHIR-based interoperability in new health domains."

"I’m so proud of this moonshot team and the creativity and energy everyone has brought to this project. We are truly making a difference. And also helping President Biden’s moonshot team to succeed," says Jay Schnitzer, M.D., Ph.D., senior vice president, corporate chief engineer, and chief medical officer.

For more information: 

White House Announcement: Improving Cancer Care Through Better Electronic Health Records: Voluntary Commitments and Call to Action | OSTP | The White House

MITRE’s Moonshots: https://www.mitre.org/our-impact/independent-research

Information about mCODE and CodeX: https://confluence.hl7.org/display/COD/mCODE; 

https://confluence.hl7.org/display/COD/CodeX+Home