{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T19:05:12Z","timestamp":1782846312214,"version":"3.54.5"},"reference-count":50,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Cancer"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cancer is a leading cause of death worldwide. Early detection through screening, diagnosis, and effective management can reduce cancer mortality. Risk assessment is crucial for improving outcomes by identifying high-risk individuals based on family history, genetics, lifestyle, and environment. Such targeted screening enhances accuracy and resource efficiency. However, the complex nature of oncology data\u2014which includes clinical observations, lab results, radiology images, treatment regimens, and genetic information\u2014presents significant challenges for data interoperability and exchange.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study proposes an oncology data model (ODM) based on the Fast Healthcare Interoperability Resources (FHIR) standard to facilitate the capturing, sharing, and processing of oncology data across various cancer care stages. We particularly focused on screening and risk assessment for 5 cancers: breast, cervical, esophageal, lung, and oral, within the Meghalaya Fourth Industrial Revolution for Sustainable Transformation Cancer Care pilot project in India.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The ODM incorporates data elements from a cancer patient\u2019s journey across 5 phases: encounter, risk assessment, clinical investigation, treatment, and outcome. Essential oncology data elements were modeled using the Health Level 7 FHIR Revision 4 standard. Custom FHIR profiles were developed for cancer-specific use cases, with terminology mapped to Systematized Nomenclature of Medicine\u2013Clinical Terms, Logical Observation Identifiers Names and Codes, and the International Classification of Diseases, 10th Revision. The implementation guide (IG) was created using FHIR Shorthand, SUSHI Unshortens Short Hand Inputs, and the Health Level 7 IG Publisher. Technical and clinical validation and a stakeholder usability assessment were conducted using a demonstration tool designed for implementer training and adoption.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The data model enhances interoperability across the cancer care continuum, from screening to treatment. The resulting IG includes 25 oncology-specific resource profiles and 50 standardized terminology value sets that support both semantic and syntactic interoperability. Central to the model are the FHIR Questionnaire and QuestionnaireResponse resources, customized for structured data collection in clinical and community settings, supporting cancer screening workflows. Technical validation yielded FHIR conformance and terminology binding, while clinical validation by oncologists and public health experts confirmed the usability and relevance of 5 screening questionnaires. The demonstration tool promoted stakeholder engagement and practical evaluation of the FHIR profiles.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The FHIR-based ODM offers a unified framework for structured, interoperable cancer data exchange from screening to after treatment. This study marks the first comprehensive Indian initiative to apply FHIR standards for oncology screening and risk assessment. Integrating with national digital health systems, like the Ayushman Bharat Digital Mission, can ensure consistent data sharing across screening programs, hospitals, and registries. Future work will focus on real-world model deployment, evaluation in multiple districts, expanding to treatment and survivorship data, and promoting national adoption to inform cancer policy, research, and precision oncology efforts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/79011","type":"journal-article","created":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T02:50:08Z","timestamp":1760323808000},"page":"e79011","source":"Crossref","is-referenced-by-count":2,"title":["FHIR Standard\u2013Based Oncology Data Model for Cancer Screening: Design and Implementation Study"],"prefix":"10.2196","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4149-5954","authenticated-orcid":false,"given":"Manisha","family":"Mantri","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-0065-9390","authenticated-orcid":false,"given":"Sayali","family":"Satokar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-0802-7475","authenticated-orcid":false,"given":"Pritam","family":"Tambe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-0497-8658","authenticated-orcid":false,"given":"Cheenmaya","family":"Bhutad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2025,12,2]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21834"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.4103\/ijmr.ijmr_1821_22"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-024-13035-6"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.4103\/ijph.ijph_1587_22"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.4103\/ijmr.IJMR_5_17"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.31823"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1177\/1757975920915677"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.3390\/cancers14133076"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.7189\/jogh.08.020421"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2024.42.16_suppl.10550"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.2196\/18396"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1021\/acs.est.1c08383"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1177\/14604582241267792"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.3389\/fdgth.2024.1260855"},{"key":"ref15","unstructured":"PradhanASethiTMantriMFIRST cancer care: leveraging fourth industrial revolution technologies for cancer careWorld Economic Forum202222025-01-02https:\/\/www3.weforum.org\/docs\/WEF_FIRST_Cancer_Care_2022.pdf"},{"key":"ref16","unstructured":"HL7 standards product briefHL7 International2020-10-16https:\/\/www.hl7.org\/implement\/standards\/product_brief.cfm?product_id=491"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.2196\/21929"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.2196\/35724"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2019.103188"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2021.103953"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijmedinf.2020.104308"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.2196\/53887"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1200\/CCI.20.00059"},{"key":"ref24","unstructured":"FHIR implementation guide for ABDM v6.5.0National Resource Centre for EHR Standards India2024-02-18https:\/\/nrces.in\/ndhm\/fhir\/r4\/index.html"},{"key":"ref25","unstructured":"Ayushman Bharat Digital Mission homepageAyushman Bharat Digital Mission2022-12-07https:\/\/abdm.gov.in\/publications"},{"key":"ref26","unstructured":"Conrad launches \u2018Meg Can Care\u2019 project for cancer screening and early detection in MeghalayaHub Network20235312025-11-20https:\/\/hubnetwork.in\/conrad-launches-meg-can-care-project-for-cancer-screening-and-early-detection-in-meghalaya\/"},{"key":"ref27","unstructured":"Minutes of the FIRST cancer care - 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