Oncology encounter · prototype context
Clinical context, evidence, and downstream use
Source-linked facts remain separate from derived outputs.
One structured oncology record supports multiple downstream workflows.
Destination routing
patient-level source classOncology Record
provenance retained
Longitudinal oncology record
source-linked · longitudinal · missingness visibleCondition/cancer-001
Observation/stage-001
Observation/variant-001
human review required
validation gate
privacy release
Evidence ledger
click source to verifyProvenance graph
FHIR source → structured factPotential use and brief observations
Short notes from clinicians, informaticians, public-health professionals, researchers, nurses, registrars, and other potential users.
Longitudinal record with source-level verification
Facts, missingness, and transformations remain inspectable throughout the workflow.
Current structured profile
synthetic record| Concept | Canonical value | State | Source |
|---|---|---|---|
| Primary cancer | Ovarian cancer | OBSERVED | |
| Stage | FIGO Stage III | OBSERVED | |
| Genomics | BRCA1 pathogenic | OBSERVED | |
| ECOG | — | UNKNOWN | no source |
| Prior PARP inhibitor | — | UNKNOWN | insufficient medication history |
Clinical state completeness
not a risk scoreDirectly represented in the synthetic FHIR source.
Missing evidence remains visible and cannot silently become a match.
Transformation ledger
source → standardization → destinationFHIR source graph
Patient, Condition, Observation and Genomics resources remain authoritative.
Structured oncology record
Standardizes clinical semantics while retaining source identifiers and uncertainty.
Registry reporting
Applies destination-specific policy, terminology, validation, and release rules.
Candidate trials with criterion-level evidence
Structured contradictions are excluded; unresolved criteria remain visible for protocol review.
Candidate queue
3 candidatesBRCA-associated ovarian cancer maintenance study
Platinum-sensitive ovarian cancer precision study
Advanced gynecologic malignancy basket study
NCT-SYN-001 evidence matrix
candidate only · final eligibility requires protocol reviewOvarian cancer required
18–80 years
Female
Pathogenic alteration
Performance status required
Protocol-specific exclusion review
Registry candidate with validation before release
The same source facts support registry reporting without a second oncology abstraction workflow.
Registry reporting pathway
candidate package · not yet declared CCRR conformantSource FHIR
Patient + primary cancer + stage + genomics + treatment evidence.
Registry candidate
The registry candidate preserves references to the original source resources.
Validation gate
Published CCRR profile validation is required before a conformance claim or release.
Source-to-report traceability
field lineage| Registry concept | Source | State |
|---|---|---|
| Primary site / disease | Condition/cancer-001 | TRACEABLE |
| Stage | Observation/stage-001 | TRACEABLE |
| Genomic finding | Observation/variant-001 | TRACEABLE |
| ECOG | Unavailable | MISSING |
Release guardrails
Critical profile failures block a conformance claim.
Each current synthetic fact resolves to a source reference or explicit missingness.
Published baseline and implementation-guide versions are declared rather than silently tracking latest.
Aggregate geography without exposing patient locations
Patient-level routing is blocked before the map layer; only policy-released aggregates are rendered.
Privacy release gate
Population products do not receive direct identifiers.
Raw geocoded points never enter the browser map product.
Low-count cells are suppressed or generalized before release.
Contextual measures are not represented as measured individual exposure.
Implementation and validation status
Implemented code, local tests, and external validation are deliberately separated.
Release evidence
local package validation| Gate | Status | Interpretation |
|---|---|---|
| Repository self-audit | PASS | package structure, claim boundaries, public ports |
| Python tests | PASS | unit/integration synthetic scenarios |
| C++ kernels | PASS | distance primitives |
| SMART external test | PENDING | must be executed against actual sandbox |
| HL7/mCODE/Genomics validation | PENDING | formal validator evidence required |
| CCRR validation | PENDING | registry conformance not yet claimed |
Audit log
prototype dataCoordinated oncology care plan
Care tasks, unresolved data, ownership, and source status in one workspace.
Current workflow plan
prototype tasks| Item | Owner | State |
|---|---|---|
| Review performance-status documentation No structured ECOG source | Care team | OPEN |
| Review BRCA-associated trial candidates | Research team | READY |
| Registry candidate validation | Registrar | PENDING |
| Navigation screen follow-up | Navigator | OPEN |
Care team
Patient-reported symptom monitoring
Severity and change are translated into workflow priority while clinical decisions remain with the care team.
Weekly symptom report
synthetic PRO dataWorkflow state
Nausea meets the configured prototype workflow threshold.
Follow-up remains a care-team action, not an automated treatment decision.
Real-patient thresholds require validated instruments and institutional approval.
Multidisciplinary case review
Source facts, unresolved questions, and multidisciplinary recommendations are kept distinct.
Pre-meeting case summary
source-linkedMultidisciplinary review
Entered by the multidisciplinary care team. Recommendations are versioned and remain separate from source FHIR facts.
Continuity across the cancer trajectory
Supportive care, goals of care, palliative-care status, and survivorship planning remain visible without replacing clinician judgment.
Supportive care
Patient-reported symptoms flow to the clinical review workspace.
Referral status and goals-of-care documentation can be represented independently of prognosis.
Goals & preferences
No structured goals-of-care document is present in the current synthetic record.
Survivorship
The prototype stores survivorship plan items, late-effect domains, follow-up ownership, and source references. Diagnosis- and treatment-specific recommendations require governed clinical content.
Research cohort discovery
Structured disease, stage, genomics, and workflow variables can be reused for research without a second abstraction pipeline.
Cohort builder
Current synthetic cohort
Ovarian cancer · FIGO III · BRCA1 pathogenic variant
Consultation support with source-linked facts
Patient-friendly questions and structured facts support shared discussion without generating an autonomous treatment recommendation.
What is known
from the structured recordQuestions for the consultation
- What is the goal of the current treatment plan?
- Which benefits, risks, and uncertainties are most important for this decision?
- Are there clinical trials that should be reviewed?
- What symptoms or treatment effects should prompt contact with the care team?
- What practical barriers could affect treatment or follow-up?
Outcome estimates and treatment recommendations require validated evidence, licensed clinical content where applicable, and clinician review.