Across Healthcare announces the eDocSS app, an EHR integrated application that allows surgeons and institutions to comply with new Commission on Cancer Synoptic Operative Report Standards


Evidence-based research indicates that surgical outcomes related to cancer patients such as quality of life and survival can be improved by adhering to specific operative techniques. In addition, replacing narrative operative dictations with synoptic operative reports can improve the capture of vital cancer surgery information. With these facts in mind, the 2020 Commission on Cancer (CoC) standards for accreditation now require synoptic operative reports (SORs) for four new operative standards that span colon, breast, and melanoma surgery.

To facilitate implementation of these operative standards, Across Healthcare co-developed the electronic Documentation of Surgery Standards (eDocSS) app with the American College of Surgeons (ACS). This app, which is embedded into electronic health records (EHRs), provides surgeons with ACS- developed Synoptic Operative Reports (SORs) that include evidence-based data fields, linkages to appropriate coding standards, and detailed explanatory notes to facilitate accurate completion of the report. Across Healthcare is working closely with EHR vendors to embed the app using a standards-based SMART on FHIR framework, that aligns with the 21st Century Cures Act final rule, to speed implementation and adoption.

“As one of the most advanced cancer centers in the country, Helen F. Graham Cancer Center within the Christiana Care Health System, was honored to be the initial site for the eDocSS app," said Dr. Karen Louie, Breast Surgeon. “With the app embedded into our Cerner PowerChart, this makes completing a synoptic operative report very efficient for our surgeons.”

The eDocSS application includes the following:

"We were blessed to work closely with the experts at ACS as well as many surgeons across the country to develop the eDocSS app," said Jason Colquitt, CEO of Across Healthcare. "Our focus will now shift to supporting the more than 1,500 CoC accredited cancer programs that need to comply with the new CoC operative standards.”

Currently, there are three SORs available in the eDocSS app. The ACS CSSP (Cancer Surgery Standards Program) team is planning to develop over 45 SORs that will all be available within eDocSS as they are released. Additional management and maintenance of the SORs within eDocSS will be handled by Across Healthcare. The eDocSS app is available to both CoC and non-CoC surgeons and institutions.

To learn more about eDocSS visit www.eDocSS.app or contact us at info@edocss.app.

SMART™ and the SMART logos are trademarks of The Children’s Medical Center Corporation. Used with permission.

Synoptic Operative Reporting Made Simple

An application co-developed with the American College of Surgeons intended for surgeons to document critical elements of cancer surgery and satisfy new patient care expectations and protocols as defined by the Commission on Cancer (CoC).

eDocSS Application Integration Meets


The electronic Documentation of Surgery Standards (eDocSS) application was co-developed with the American College of Surgeons and allows structured documents and reports to be created, curated, and shared with institutions and individuals to support point-of-care workflows. The eDocSS application allows for data to be prepopulated from the Electronic Health Record (EHR) into the report where and when available to reduce data entry burden and increase quality. eDocSS is working with all of the top EHRs and has been specifically focused on capturing structured data for Synoptic Operative Reports (SORs) using the SMART on FHIR framework. For guidance within the application, users are prompted and have explanatory notes aligned with the CoC standards for content and surgical billing codes.



The cancer data fields available within eDocSS have been developed by the American College of Surgeons. Vital cancer information on surgical staging, key findings, and key procedural approaches are documented in a standardized manner to maintain CoC compliance.


Pre-existing fields are pulled from the patient record, and the surgeon needs only to verify the information or edit as needed.

CoC Standards

Fulfills the synoptic operative reporting requirements for the Commission on Cancer 2020 operative standards 5.3 through 5.6.

American Joint Committee on Cancer (AJCC) TNM Staging System

TNM categories are incorporated into any data fields related to staging.

National Cancer Database (NCDB) Codes

Select NCDB codes and definitions from the Standards for Oncology Registry Entry (STORE) manual that are relevant to the data fields in the app.

EHR Integration

eDocSS uses SMART on FHIR and will be integrated with top EHR vendors. This application is not a standalone app, but rather uses Single Sign On (SSO) and embeds inside the workflow of the EHR.

Read about eDocSS in the news!



The American
College of Surgeons

The eDocSS application was co-developed by Across Healthcare with the American College of Surgeons (ACS). Through eDocSS, surgeons will meet the 2020 CoC Synoptic Operative Reporting requirements. Additionally, with eDocSS there is no need to worry about your EHR vendor or your staff having to update content because eDocSS will always have the most current ACS created SORs, content changes, explanatory notes aligned with the CoC standards, and more!


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