A CONTOUR BY ANY OTHER NAME: PROVINCIAL LOGISTICS OF IMPLEMENTING THE PAN-CANADIAN DATA STRATEGY

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Standardizing oncology data is essential for improving patient care, optimizing treatment pathways, and advancing research. Since 2018, the American Association of Physicists in Medicine (AAPM) has led efforts to develop TG-263 (radiotherapy nomenclature) and the Operational Ontology for Oncology (O3). However, aligning these standards with clinical practice remains a challenge. The Pan-Canadian Cancer Data Strategy, launched by the Canadian Partnership Against Cancer (CPAC) and the Canadian Cancer Society (CCS), has identified radiotherapy (RT) as a key focus for structured oncology data implementation. Spearheaded by the provinces of Ontario (ON) and Nova Scotia (NS), this initiative seeks to standardize and integrate oncology data, ultimately improving patient outcomes and supporting evidence-based decision-making. An early-adopter initiative was launched in ON and NS, engaging 15 RT programs in ON and 2 RT sites in NS to evaluate the feasibility of TG-263 and O3 adoption. Key focus areas included: • Standardizing nomenclature for structured RT data capture • Exploring tools for standard nomenclature and contour naming • Evaluation of tools for compliance auditing, structure naming corrections, and enhancing automated data validation and processing • Assessing the feasibility of O3 implementation across centres with diverse infrastructure and workflows A current state evaluation examined data standardization practices, infrastructure and feasibility across participating centres. Challenges and opportunities in establishing a pan-Canadian RT data standard include: • Challenges: • mobilizing resources, whether human or financial, to promote adoption • partner buy-in is crucial, within radiation treatment programs and among clinicians, recognizing the importance of standard nomenclature • evaluating the pros and cons of the numerous vendor and open-source compliance auditing tools available and sustainability considerations. • interoperability of tools with various radiation therapy software systems particular within a mixed vendor environment • Opportunities: • Evaluate the feasibility and scalability of the initiatives, including TG-263 and O3 adoption • share lessons learned to provide support and further collaboration between the two provinces and at a pan-Canadian level as other programs pursue this initiative Findings from the early-adopter programs will provide blueprint for a broader pan-Canadian rollout, including the validation of tools for nomenclature and auditing to guide data linkage improvements. These lessons learned will serve as a foundation for standardizing and integrating oncology data, ultimately enhancing patient outcomes and supporting evidence-based decision-making.

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