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Background: Electronic health record (EHR) based research in oncology can be limited by missing data and a lack of structured data elements. Clinical research data warehouses for specific cancer types can enable the creation of more robust research cohorts.

Methods: We linked data from the Stanford University EHR with the Stanford Cancer Institute Research Database (SCIRDB) and the California Cancer Registry (CCR) to create a research data warehouse for prostate cancer.

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The mobility of doctors and patients asks for multilingualism of electronic health record (EHR) systems: Doctors might face language problems using foreign medical information systems; people working abroad ask for continuous care which requires the treating physician to consult and understand the patient's health record. To address these linguistic and interoperability issues a solution is being developed that is based on widely acclaimed standards. Medical concepts that are derived from ASTM CCR define an interface model (based on ISO 13606).

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Objectives: The current volume and complexity of genetic tests, and the molecular genetics knowledge and health knowledge related to interpretation of the results of those tests, are rapidly outstripping the ability of individual clinicians to recall, understand and convey to their patients information relevant to their care. The tailoring of molecular genetics knowledge and health knowledge in clinical settings is important both for the provision of personalized medicine and to reduce clinician information overload. In this paper we describe the incorporation, customization and demonstration of molecular genetic data (mainly sequence variants), molecular genetics knowledge and health knowledge into a standards-based electronic health record (EHR) prototype developed specifically for this study.

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