EOM participants are oncology physician group practices (PGPs) that prescribe and administer chemotherapy for cancer. As detailed in the Enhancing Oncology Model (EOM) Clinical Data Elements Guide, version 2.1 (June 4, 2024).

• Breast Cancer
• Chronic Leukemia
• Lung Cancer
• Lymphoma
• Multiple Myeloma
• Prostate Cancer
• Small Intestine/Colorectal Cancer

Modeling Considerations

Cancer types

EOM is limited to seven cancer types and further specifies conditional filtering of cancer subtypes, namely, "low-risk" breast cancer and "low-intensity" prostate cancer. It is important that EOM participants closely follow the model-specific guidance related to acceptable LOINC, SNOMED, and/or ICD-10 codes and/or acceptable value set response options that are not only conformant with this EOM IG specifically, and mCODE generally, but also aligned with model requirements. View the General Guidance section for additional information.

Biomarkers

EOM scopes further constraining TumorMarkerTest for contextual biomarkers relative to the seven scoped cancer types.

• patient identifier invariants that require a minimum of a Medicare Beneficiary Identifier (MBI).

History of metastatic cancer

EOM specifies history of metastatic cancer as one element. To address this gap, mCODE created a dedicated profile called History of Metastatic Cancer. There are other ways that metastasis could be captured in mCODE, but for the purposes of EOM, this new profile will be leveraged.

mCODE groupings

The EOM IG specifier can collectively represent these requirements in 2 ways:

• As a CapabilityStatement - this is beneficial in narrowing server and client messaging and query requirements of relevant FHIR resources.
• As a FHIR Bundle - this may be a better option for specifying a collection of relevant resources as EOM submission requirements. As such, this is the initial approach to be tested for EOM.

Partial examples are included in this IG for illustrative purposes:

• EOM as a CapabilityStatement
• EOM as a FHIR Bundle