Abstract: Cancer care is increasingly more complicated due to increasing therapeutic options and is often difficult to access information critical to clinical decisions as a result of the frequency of new studies and decentralization of complex clinical evidence. Patient genomic and other clinical information is critical for making timely and accurate oncology and health care decisions is often in narrative text format scattered across multiple reports and IT systems. It is critical for treatment to encode clinical knowledge pertinent to clinical decision making in an easily accessible form. Discretized information in a digital patient file can assist in creating and selecting relevant therapies based on the body of medical and genomic testing history for a given patient. Discretized information is linked to a pathway execution engine and dynamically updated clinical trial matches. An authoring tool assists in creating pathways for the pathways execution engine to drive care through clinical decision trees.