# Oncology EHR and real-world data platforms

Source: https://onco.cc/technologies/oncology-real-world-data/  
OnCo record `oncology-real-world-data` (Technology). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Databases built from millions of real patient records, used to see how treatments work outside trials and to run studies without new trials.

## Summary

Flatiron Health (Roche; oncology EHR OncoEMR plus the Flatiron-Foundation clinico-genomic database), Tempus (multimodal clinical-molecular data), ConcertAI, COTA, Syapse, TriNetX, Komodo Health, Optum, and Datavant (tokenised linkage) assemble and curate real-world oncology data. Used for external control arms, label expansions (FDA's RWE framework), health-economic models, and biomarker discovery; standardisation via OMOP/OHDSI and mCODE (HL7 FHIR) is the interoperability layer.

## Fields

- Kind: Technology
- Status: established
- Last checked: 2026-09-08
- Tags: supporting
- Principle: Structured and abstracted EHR data, claims, genomics, and mortality linked with privacy-preserving tokens; curated to common data models and analysed with target-trial emulation methods.
- Strengths: Scale and speed; Populations trials exclude (older, sicker, rarer)
- Limitations: Confounding and missing data; Inconsistent endpoints (real-world progression); Access and cost

## Sources

- FDA: Real-World Evidence programme: https://www.fda.gov/science-research/science-and-research-special-topics/real-world-evidence

## Connected records

- fronts: [AI & Computation](https://onco.cc/fronts/ai-computation/), [Diagnostics & Biomarkers](https://onco.cc/fronts/diagnostics/)
- technologies: [AI trial matching & clinical decision support](https://onco.cc/technologies/ai-trial-matching/), [Cancer registries and population surveillance](https://onco.cc/technologies/cancer-registries-surveillance/), [Community oncology and site networks](https://onco.cc/technologies/community-oncology-networks/), [Comprehensive genomic profiling](https://onco.cc/technologies/cgp/), [Federated learning and privacy-preserving AI](https://onco.cc/technologies/federated-learning-medical-ai/), [Genomics cloud and secure research environments](https://onco.cc/technologies/genomics-cloud-platforms/), [Oncology EHR modules and treatment pathways](https://onco.cc/technologies/hospital-information-systems-oncology/)
- companies: [ConcertAI](https://onco.cc/companies/concertai/), [COTA](https://onco.cc/companies/cota-healthcare/), [Datavant](https://onco.cc/companies/datavant/), [Epic Systems](https://onco.cc/companies/epic-systems/), [Flatiron Health (Roche)](https://onco.cc/companies/flatiron-health/), [IQVIA](https://onco.cc/companies/iqvia/), [Komodo Health](https://onco.cc/companies/komodo-health/), [McKesson / The US Oncology Network](https://onco.cc/companies/mckesson-us-oncology/), [Tempus AI](https://onco.cc/companies/tempus/), [TriNetX](https://onco.cc/companies/trinetx/)
- terms: [21st Century Cures Act](https://onco.cc/terms/21st-century-cures-act/), [European Health Data Space Regulation (EU) 2025/327](https://onco.cc/terms/european-health-data-space/), [External and synthetic control arms](https://onco.cc/terms/external-control-arm/), [GDPR and health data (Regulation (EU) 2016/679)](https://onco.cc/terms/gdpr/), [HIPAA (Health Insurance Portability and Accountability Act)](https://onco.cc/terms/hipaa/), [mCODE (minimal Common Oncology Data Elements)](https://onco.cc/terms/mcode/), [OMOP common data model and OHDSI](https://onco.cc/terms/omop-ohdsi/), [Real-world evidence](https://onco.cc/terms/real-world-evidence/), [Registry-based randomised trial](https://onco.cc/terms/registry-based-trial/), [UK Data Protection Act 2018 and health data law](https://onco.cc/terms/uk-data-protection-act/)

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