Safe Implementation of Computerized Provider Order Entry for Adult Oncology

Applied Clinical Informatics
D B MartinT H Payne

Abstract

Oncology has lagged in CPOE adoption due to the narrow therapeutic index of chemotherapy drugs, individualized dosing based on weight and height, regimen complexity, and workflows that include hard stops where safety checks are performed and documented. We sought to establish CPOE for chemotherapy ordering and administration in an academic teaching institution using a commercially available CPOE system. A commercially available CPOE system was implemented throughout the hospital. A multidisciplinary team identified key safety gaps that required the development of a customized complex order display and a verification documentation workflow. Staff reported safety events were monitored for two years and compared to the year prior to go live. A workflow was enabled to capture real-time provider verification status during the time from ordering to the administration of chemotherapy. A customized display system was embedded in the EMR to provide a single screen view of the relevant parameters of chemotherapy doses including current and previous patient measurements of height and weight, dose adjustments, provider verifications, prior chemotherapy regimens, and a synopsis of the standard regimen for reference. Our system went live wit...Continue Reading

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Citations

Aug 23, 2019·European Journal of Cancer Care·Valentina LichtnerJohanna I Westbrook
Aug 17, 2020·BMC Medical Informatics and Decision Making·Valentina LichtnerJohanna I Westbrook
Feb 25, 2021·European Journal of Clinical Pharmacology·Suresh Kumar SrinivasamurthyUppugunduri Satyanarayana Chakradhara Rao

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