Ontada finds cancer evidence in the everyday

A cancer record can tell two stories at once. One is arranged in tidy fields: a diagnosis, a medication, a date. The other runs through the notes and reports, where a clinician describes what changed, what the patient could tolerate, or what a test revealed. The first story is convenient for a computer. The second may contain the detail a researcher actually needs.

Ontada earns its place in that gap. The McKesson business supplies software to oncology practices, turns their records into research data, and helps life sciences companies interpret what happens when cancer treatments meet ordinary clinical life. It has an unusually useful vantage point: the tools at the bedside and the machinery downstream belong to the same oncology ecosystem.

The evidence between the fields

Consider the distinction between knowing that a drug was prescribed and knowing why it was stopped. Both are useful. They answer different questions. A treatment sequence alone cannot supply every detail about response, tolerability or a clinical decision. Ontada’s research offering explicitly spans structured records and chart abstraction, including customized longitudinal studies.

This is the territory of real-world data: information collected through routine care rather than created solely for an experiment. Real-world evidence is what a suitably designed analysis can draw from it. The distinction matters. A mountain of records is an input, not a conclusion. Someone must decide what counts as a patient, a treatment line, an outcome and a meaningful comparison.

Ontada employs that someone in several forms: oncologists, epidemiologists, outcomes researchers, biostatisticians and data abstractors. Its research service covers proposal through publication. The attraction for a customer is access to both the material and people who understand the peculiarities of oncology records.

A business born with a head start

McKesson launched Ontada in December 2020 by combining existing research capabilities and oncology technologies, including iKnowMed and Clear Value Plus. That origin explains more than a romantic tale about a founder with a laptop could. Ontada arrived with working tools and relationships in community oncology.

The name combines “oncology” and “data,” an admirably brief business plan. But the software underneath it was older: McKesson’s 2021 investor presentation traced iKnowMed’s roots to the 1990s and its development alongside oncologists. A new name had been put around an established clinical position.

Today, Ontada reports roughly four million available patient records and more than 2,800 providers using iKnowMed. Those figures describe different things. They are not four million current software customers. Similarly, the two million patients seen annually by The US Oncology Network and Onmark practices describes the broader clinical footprint.

The clinic is also the input

iKnowMed is an oncology-specific electronic health record. Its surrounding tools address treatment decisions, patient communication and practice performance. Clear Value Plus supports regimen selection; Practice Insights addresses clinical, financial and operational analysis; Ontada Health supplies patient-facing portal and registration functions.

The advantage is practical. If a new biomarker becomes relevant, the clinical workflow needs somewhere to put it. If the record captures it consistently, a later study has something more useful to work with. Ontada’s June 2025 molecular mapping guidance shows the care involved: results from testing vendors can populate supported disease fields, with distinctions between a negative result and an unknown or unperformed test.

There are conditions attached. That mapping functionality is described as available to eligible US Oncology Network practices with the relevant Sarah Cannon Research Institute and Genospace agreements. A feature described on a product page should never be mistaken for a capability every customer automatically receives.

The reader that had to scale

The difficulty was volume. Ontada’s October 2024 Microsoft announcement described more than 150 million unstructured oncology document components. Its data science team targeted close to 100 oncology elements across 39 cancer types. Reading this material manually would impose an obvious limit on how much could become useful data.

“We were collecting the right data”Amy O’Sullivan, Chief Research Officer, in Microsoft’s customer account

Microsoft’s February 2025 account describes a six-month development effort, scalability barriers in earlier language-model approaches, and the use of batch processing. ON.Genuity combines extracted clinical information with structured records. Ontada reported four-times-faster access to unstructured data; Microsoft’s account says 150 million documents were processed in three weeks.

The reported gains concern processing and access. They do not establish a fourfold improvement in survival or drug approval speed. The interesting operational change is that more clinical detail can be considered without requiring someone to read every page by hand. Its scientific value depends on whether that detail is extracted and interpreted correctly.

Two customers, different questions

For a research team, the question might concern treatment patterns, comparative outcomes or an external control arm. ON.Journey integrates iKnowMed records with claims in a standardized longitudinal dataset. Its product description lists 13 tumor types and more than 150 oncology-specific elements. That packaged scope is narrower than the business’s total research coverage, an important distinction for anyone shopping by headline numbers.

A commercial team asks something else: where are therapies being adopted, which providers see a relevant population, and how might demand change? Trinity Life Sciences announced a collaboration in May 2025 combining its analytics with Ontada data for patient journeys, forecasting and provider segmentation. Ontada Learn adds education delivered through digital channels, practice programs and events.

These offerings make Ontada a business-to-business supplier of technology, licensed data, commissioned research and education services. A published trial-emulation study identifies its data as used under license. The business has several ways to charge for the expertise surrounding a record, rather than a single consumer subscription.

Flatiron Health is a close alternative: it also combines oncology practice technology with real-world evidence. Ontada’s distinguishing argument is its McKesson connection and community oncology relationships. For buyers, the sensible comparison is concrete: relevant patients, available variables, traceable provenance and a dataset suited to the endpoint.

A mutation needs a timeline

A molecular profile says something about a tumor. Treatment history adds another dimension: what happened before the sample, what came afterward, and what response was recorded. In January 2025, Caris Life Sciences announced a collaboration pairing its molecular expertise with Ontada’s clinical data and research capabilities.

ON.Multiomics now describes biomarker-defined cohorts linking Caris profiling with longitudinal community oncology records. Its specification includes whole-exome and whole-transcriptome sequencing, pathology information and more than 1,000 curated EHR variables. The promise is a better-defined research population, with biological signals placed in the context of actual treatment.

The network is also expanding. In May 2026, Ontada announced the integration of Florida Cancer Specialists & Research Institute data, including more than 530 providers. The value of a larger footprint is the additional clinical experience it may capture. Researchers still need to examine who is represented and where documentation is complete.

The cost includes the changeover

Infrastructure changes bring a less glamorous bill. Ontada’s migration guidance scheduled iKnowMed’s move from McKesson-managed data centers to Azure for January 24-25, 2026. It described a pause in new iKnowMed features during the transition and an extended maintenance window, with read-only access available.

For a practice, a technology purchase therefore includes workflow adaptation, integration and continuity planning alongside the contract. The useful lesson is to make those arrangements explicit. A migration that looks elegant on a diagram must still accommodate a patient form submitted while the main system is unavailable.

The question survives the machinery

Ontada’s FDA contract, announced in October 2023, supplies a particularly clear example of the business’s purpose: study the natural history of rare cancers in community oncology. The objectives concern how patients present, how treatment decisions unfold and how the journey compares with other data sources. The commission was for research, not a blanket regulatory endorsement of every Ontada dataset.

Observational comparisons also retain their familiar difficulty. Patients receiving different treatments may differ before treatment starts. Missing information can distort a cohort. A sophisticated extraction system cannot recover a fact that nobody recorded. Ontada’s own research activity includes methods for addressing missing data.

There is a lesson here that travels well beyond oncology: start with the question, improve what gets captured, preserve definitions and validate the automation. Ontada’s position is interesting because it can work along that chain. The ordinary clinical record, properly handled, gets a second useful life.