The Centre for Oncology Informatics (COI) is a subdivision of the Illawarra Health & Medical Research Institute (IHMRI). Like the IHMRI, the COI seeks to bring together oncology clinicians with an informatics interest and informaticians with a desire to undertake clinically relevant oncology research. We believe that this collaboration will drive good Informatics research into clinically meaningful Information Systems.

Oncology faces two large challenges - how to apply what we know already, and how to collect and assimilate knowledge for the future to improve patient outcomes. To meet these challenges we need new Information systems.

What is wrong with the information systems we have? At present, oncologists use very expensive commercial products based on out of date technologies within their departments.

This means that oncologists cannot develop their information systems in new ways to meet and drive future challenges. Furthermore technologies are unlikely to change until a commercial vendor loses ascendancy, as working products are left unaltered. Furthermore commercial deployments inside departments tend to be very large pieces of software that try to manage all facets of a department, and as such, are difficult to know well and tend to frighten those who are technologically challenged. This group happens to involve many senior clinicians. The result is that commercial software as a rule is poorly deployed in corporate settings.

For informaticians, our present information systems are unhelpful. Few clinicians know how to use them properly, so data capture is patchy. The old and copyright technologies makes writing extensions difficult, so while new informatics programs may take data out, they are unable to store their results in the same place. And the proprietary nature of the system means that the additional programs are not disseminated , unless provided by the vendor - for which there is a cost.

Some of us believe that a paradigm shift is required. Individual oncologists who wish to collect their data need to have a readily available, personal, inexpensive solution which they can help develop. The solution has to model oncological knowledge accurately. And it has to provide the Informatics community with a backbone from which the results of research can be verified and then applied. Areas of Informatics research such as Oncology Ontologies, Business Process Design, Argumentation in Medical Management, Clinical Knowledge Markup Languages, Patient Community access for Patient Derived Assessments, Collaborative reporting and Context/patient-specific data presentation need support in a clinical framework. Medical research will be permitted in new ways in areas such as Prognostication, Outcome Research and Bioinformatics integration (caBIG), as well as supporting optimized work flow for clinical trials and protocols.

Because we believe in the crucial need for consistent and coherent data gathering to improve patient outcomes in the oncologist's workspace, we do not see a place for commercial competition in matters relating to information about the control of cancer. It is our hope that in time when our information system is robust, the commercial vendors will seek to use it as their plug in for the oncologist's workspace. In fact we are inviting vendors to link with us in developing the system.

We also invite support from community organizations. Few people have not been affected by cancer within their family, if not personally, and while the community often expresses the desire to see cancer controlled, few will realise the importance of information in achieving this end. If they did, they would urge oncologists and informaticians to work together to solve their problem.