Co-authored by:
Edward P. Ambinder, MD
Jeremy L. Warner, MD

The cancer journey, from diagnosis to treatment to survivorship, involves multiple interventions and stakeholders. Survivorship begins after completing a bulk of the definitive treatment, and addresses psychosocial developments, as well as late medical issues, resulting from treatment. In 2014, the American Society of Clinical Oncology (ASCO) released a new generic (rather than disease-specific) Survivorship Care Plan (SCP) template. Collaborating with ASCO’s Health IT Work Group (WG), Lantana transformed the SCP into a C-CDA in 2015. This is the third iteration of work on the HL7 Clinical Oncology Treatment Plan and Summary (COTPS), now encompassing the SCP.

COTPS provides a focused summary of pertinent medical history for cancer patients; including cancer evaluations, cancer treatment summaries, clinical guidance for expected outcomes, follow-up recommendations, and routine testing during survivorship. Following successful chemotherapy, COTPS updates patients, caregivers, and medical providers.

The Commission on Cancer (CoC) endorsed ASCO’s new SCP based on its inclusion of the minimum critical data required for survivorship care[1]. The project was prioritized in 2015, because the CoC must provide all patients with survivorship care plans by 2019, including both a summary of curative treatment and a care plan with follow-up recommendations[2]. The SCP also provides recommendations, as well as critical information related to long-term care, for care providers[3]. COTPS eliminates the need for time-consuming manual extraction of treatment plan and summary data into a paper form. These documents, which support shared authors, can also be used for research and registry purposes.

Lantana and the WG began developing oncology-specific interoperability standards in 2012. They selected ASCO’s suite of Chemotherapy Treatment Plan and Summary templates, initially released in 2009, as a baseline for COTPS due to an increasing need for efficient data sharing. The first iteration of COTPS was developed using ASCO’s Breast Cancer Adjuvant Treatment Plan and Summary (BCTPS). COTPS Release 1 (R1) was published by HL7 in 2013. The second iteration was developed using ASCO’s Colon Cancer Adjuvant Treatment Plan and Summary template (CCTPS); it was published in 2014. In 2015, HL7 published a minor release of COTPS R2.1 with updated codes.

Published versions of COTPS are freely available for download. To see the original BCTPS and CCTPS paper-based templates, click here.

[1] Deborah K. Mayer, PhD, Larissa Nekhlyudov, MD, MPH, Claire F. Snyder, PhD, Janette K. Merrill, MS, Dana S. Wollins, MGC, and Lawrence N. Shulman, MD. American Society of Clinical Oncology Clinical Expert Statement on Cancer Survivorship Care Planning, Journal of Oncology Practice, October 14, 2014.

[2] https://www.facs.org/publications/newsletters/coc-source/special-source/standard33

[3] http://jco.ascopubs.org/content/early/2015/12/07/JCO.2015.64.3809