Abstract: The overall goal of this project is unchanged. It is for the Holden Comprehensive Cancer Center (HCCC) to collaborate with the Big Ten Electronic Health Record Consortium (BT-EHRC) to enhance Electronic Health Record (EHR) investigational research plans by standardizing processes, developing a master assessment of EHR treatment plan modules, building such modules for a pilot series of trials, and determining how effective such modules will be as applied broadly. The specific aims of the original overall application included: Aim 1. To retrospectively analyze similarities and differences of EHR treatment plans design and implementations across the member institutions in the BT-EHRC. Aim 2. To develop novel tool kits that promote optimized activation of National Clinical Trials Network (NCTN) clinical trials by facilitating and expediting EHR implementation of treatment plans. Aim 3. To prospectively validate these EHR treatment plan implementations across BT-EHRC and other institutions. Most progress over the past year has focused on Aim 1. A comprehensive pilot evaluation of content, build format and institutional workflows was performed on two NCTN protocols that were built into various institutional EHRs. This revealed high variability between institutions based partially, but not fully on the EHR vendor (Cerner, Epic or other) used. Based on this experience, the group developed two subcommittees to focus on analysis of the protocols and on technical aspects of electronically transmitting content into EHRs, both of which were issues during the pilot phase. For the second year of this supplement, HCCC will focus on collaborating to construct a framework in which standardized treatment plans can be shared across different sites for implementation and validating the new framework.