Case study · Federation
Flatiron analyzes oncology data across four countries, data in place
Flatiron Health describes its Trusted Research Environment as “Powered by Lifebit CloudOS”: approved researchers analyze its longitudinal oncology data across countries and export only reviewed results. The data never leaves the source.
01 · The challenge
Cross-border oncology research under national rules
Flatiron’s oncology data sits in region-specific datasets, each under its own data protection rules. Moving patient-level records across borders was not an option.
Governed analysis across distributed oncology datasets without centralizing data
Reprocessing and validating data refreshes at scale
Coordinated updates and analyses across jurisdictions
02 · What we deployed
A federated TRE for clinical oncology
Approved researchers connect into the environment, analyze Flatiron’s data where it lives, and export only aggregate results through an airlock. Flatiron describes it as a secure platform for cross-country cohort analyses that keeps data under local control. The data is refreshed every 90 days and includes unstructured records such as genomic testing reports and physician notes.
Compute to data
Patient-level records never reach a researcher’s laptop, cloud account, or institution.
Airlock-controlled outputs
Aggregate statistics and model coefficients leave through automated review.
Harmonized for pooled analysis
US and Japan datasets were harmonized to a standard model for cross-country analysis.
How it works
From connected data to approved results
Flatiron’s de-identified, EHR-derived oncology datasets stay in Flatiron’s own secure environment, under each country’s rules.
Country datasets are harmonized to Flatiron’s common data model, so US and Japan data can be pooled for cross-country analysis.
Approved researchers analyze the data in place; access controls stop any use beyond the approved research.
Only aggregate, disclosure-controlled results leave the environment after airlock review.
What’s in the stack
Lifebit products used: Trusted Research Environment · Airlock
03 · The results
Cross-country evidence without moving data
Flatiron’s international network tripled in 2024–25 and grew nearly 70% again in the year to July 2026, to more than 50 hospitals and research sites across the UK, Germany, and Japan. Approved researchers analyze the de-identified data in Flatiron’s Trusted Research Environment, built on Lifebit CloudOS, and only reviewed results leave. In 2024 Flatiron added Japanese gastric, colorectal, and breast cancer datasets and pooled US and Japan data for a study of early-onset gastric and colorectal cancer, presented at ACPE in Tokyo. The datasets and their governance are described in a peer-reviewed paper in ESMO Real World Data and Digital Oncology (2025).
Timeline
About this use case
Federation
Real-world evidence uses patient records from routine cancer care to see how treatments work outside clinical trials. Comparing countries needs data from several markets, but privacy laws stop records from crossing borders. A federated environment harmonizes each country’s data in place and pools only the analysis, so researchers get cross-country results without moving records.
Who uses it here: Approved researchers at Flatiron, its partner hospitals in the UK, Germany, and Japan, and life sciences customers.
See how federation works
