There are three levels of interoperable informatics that are co-occurring in the United States to link data to provide more comprehensive care to patients. One is the National Health Information Network (NHIN) that is establishing use case scenarios and standards for interoperability for patients with multiple conditions. The second is the National Cancer Institute's project that supports the enterprise work called the Cancer Bioinformatics Grid (caBIG) in linking clinical care with bioinformatics, tissue repositories, and imaging for patients with cancer. The third is in the area of translating the discoveries of biology to bedside care through the National Institutes of Health (NIH) translational research efforts to get these new biomedical and genomic discoveries in practice in multiple healthcare delivery environments. These developments are becoming global networks in the diagnosis and cure of cancer as the primary outcome. This paper describes the national efforts and the global connection to Europe through the caBIG program. The European program that is beginning to link to cancer research internationally is the National Cancer Research Institute (NCRI) in the United Kingdom. They are developing the NCRI Oncology Information Exchange (ONIX) to provide the cancer research community with the ability to share information.
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