PROJECT SUMMARY Electronic health records (EHR) are used in all NCI-supported Cancer Centers. EHR data support not only the delivery of standard-of-care treatments, but also investigational diagnostic and interventional programs in clinical research. Although EHR-based care plans provide quality control for care processes, such as the administration of pharmaceuticals, these procedures vary extensively from one health care provider to another, even when the same EHR is used by both organizations. In supporting clinical trials with investigational agents, the electronic treatment plan is usually constructed from very basic data collection forms, regardless of whether a patient population is rare or common. Multi-institutional clinical trials require repeated efforts to modify different EHR systems present across potentially hundreds of institutions. The goal of this application is to create a consortium of Cancer Centers that will communicate and coordinate with the NCI and EHR vendors to facilitate and harmonize rapid implementation of EHR investigational or interventional treatment plans for NCTN clinical trials. The Ohio State University Comprehensive Cancer Center will participate in this BIG10- EHRC consortium project, which includes a Coordination Center at the Indiana University and five membership centers, including: The Ohio State University, University of Michigan, University of Iowa, Northwestern University, and Rutgers University within the Big 10 Cancer Research Consortium. The project has the following three specific aims: 1) To retrospectively analyze similarities and differences of EHR treatment plan design and implementation across the member institutions in the Big Ten; 2) To develop novel EHR treatment plan tool kits conducive to rapid opening of NCTN clinical trials; and 3) To prospectively validate EHR treatment plan implementation across Big Ten institutions.