OnCo
ideasIdea

A machine-readable treatment summary handed to every patient and readable by any hospital

Patients moving between hospitals often carry paper folders or nothing. A standard electronic summary of diagnosis, treatments, and doses that any system can read would stop repeated tests and dangerous gaps.

Cancer care crosses institutions, regions, and countries, and treatment history is frequently lost or reconstructed from memory. A standard summary (diagnosis, stage, molecular results, regimens with cumulative doses, radiotherapy fields and doses, key toxicities, follow-up plan) in an interoperable format such as HL7 FHIR mCODE, generated automatically and held by the patient, would make continuity possible. The technical standards exist; the missing pieces are mandates and defaults.

Hypothesis
Regions requiring a standard summary at each transition will reduce duplicated imaging and pathology by at least 20% and reduce cumulative-dose errors (for instance, anthracycline over-exposure) to near zero.
Rationale
Discharge summaries and immunisation records show that standardised, patient-held documents reduce errors and duplication when they are the default output of the system rather than an extra task.
What would test it
Implementation in two health systems with measurement of duplicate tests, dose errors, and time to reconstruct history in receiving hospitals.
Maturity
early clinical
Who has to act
data
Cost to try
Medium ($1M to $50M)
Years to first evidence
3
Bottlenecks it attacks
  • Fragmented care and guideline gaps · Patients fall between specialists, wait for referrals and often do not get the treatment guidelines say they should.
  • Data silos · Records, scans, genomes and outcomes sit in separate systems that cannot talk. Every patient's experience is lost to the next.
  • Survivorship and late effects are neglected · Tens of millions of people live after cancer with heart damage, infertility, second cancers and fear, and few services.

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