Assessment of efficiency and safety of the comprehensive Chemotherapy Assistance Program for ordering oncology medications

Cho, Eun; Kim, Hyo Jung; Kim, Gun Min; Kum, Jae Yong; Chung, Hye Kyung; Lyu, Chuhl Joo; Ahn, Joong Bae; Shin, Sang Joon

doi:10.1016/j.ijmedinf.2013.02.001

Cited by 12 publications

(6 citation statements)

References 44 publications

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“…Although errors were defined differently across studies, prescription errors were reduced in each of the 9 studies. 20,23–25,27–31 One study evaluated medication-related safety events, demonstrating fewer events with use of CDS. 22 Two studies evaluated pharmacy work flow, with one study showing decreased workflow fragmentation and increased continuous task time with CPOE, 26 while another study showed increased order review time with CPOE.…”

Section: Resultsmentioning

confidence: 99%

A Systematic Review of Clinical Decision Support Systems for Clinical Oncology Practice

Pawloski

Brooks

Nielsen

et al. 2019

Journal of the National Comprehensive Cancer Network

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Background Electronic health records are central to cancer care delivery. Electronic clinical decision support (CDS) systems can potentially improve cancer care quality and safety. However, little is known regarding the use of CDS in clinical oncology and their impact on patient outcomes. Methods We performed a systematic review of peer-reviewed studies evaluating outcomes of electronic CDS systems for cancer diagnosis, treatment, and supportive care. Peer-reviewed studies published between 1995 and 2016 were included if they assessed clinical outcomes, patient reported outcomes (PROs), costs, or care delivery process measures. Results Electronic database searches yielded 2,439 potentially eligible papers; 24 studies were included after final review. Most studies used an uncontrolled, pre-post intervention design. Twenty-three of 24 studies reported improvement in key study outcomes with use of oncology CDS systems. Twelve studies assessed CDS for computerized chemotherapy order entry, demonstrating reductions in prescribing error rates, medication-related safety events, and workflow interruptions. The remaining studies examined oncology clinical pathways, guideline adherence, systems for collection and communication of PROs, and prescriber alerts. Conclusions There is a paucity of data evaluating clinically relevant outcomes of CDS system implementation in oncology care. Currently available data suggests that CDS can have a positive impact on the quality of cancer care delivery. However, there is a critical need to rigorously evaluate CDS systems to better understand how oncology CDS can be implemented to improve patient outcomes.

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Section: Resultsmentioning

confidence: 99%

A Systematic Review of Clinical Decision Support Systems for Clinical Oncology Practice

Pawloski

Brooks

Nielsen

et al. 2019

Journal of the National Comprehensive Cancer Network

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“…Theirs was the final unit at the center to adopt CPOE and required "considerable effort" to develop a customized implementation. Other studies have demonstrated similar results using various commercial and in-house developed systems [19][20][21]. A CPOE system was safely implemented at St. Jude Children's Research Hospital in 2010 after technical improvements addressed safety issues [22].…”

Section: Introductionmentioning

confidence: 73%

Safe Implementation of Computerized Provider Order Entry for Adult Oncology

Martin¹,

Kaemingk²,

Frieze³

et al. 2015

Appl Clin Inform

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SummaryBackground: 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. Objectives: We sought to establish CPOE for chemotherapy ordering and administration in an academic teaching institution using a commercially available CPOE system. Methods: 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. Results: 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 with 127 chemotherapy plans and has been expanded to 189. Staff reported safety events decreased following implementation, particularly in the area of prescribing and transcribing by the second year of use. Conclusions: We observed reduced staff reported safety events following implementation of CPOE for inpatient chemotherapy using an electronic verification workflow and an embedded custom clinical decision support page. This implementation demonstrates that CPOE can be safely used for inpatient chemotherapy, even in an extremely complex environment.

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“…As suggested by Cho et al ., another underlying cause could be the complexity involved in completely fitting a CPOE system into oncohaematological medication schemes and practice. Although one study showed that 77·7% of MEs remained 3 years after implementing CPOE, it did not analyse the medication‐use process associated with antineoplastic agents and so caution should be exercised when comparing this study and the present study.…”

Section: Resultsmentioning

confidence: 99%

The impact of a computerized physician order entry system on medical errors with antineoplastic drugs 5 years after its implementation

Cuervo¹,

Sanchís²,

López³

et al. 2015

J Clin Pharm Ther

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The CPOE system almost completely eliminated MEs with antineoplastic drugs in the Haematology Department. No new types of MEs were observed once physicians had become accustomed to using the system. However, some MEs were not eliminated. Constant diligence is needed to analyse and evaluate MEs associated with the CPOE system and their causes, such that the limitations of CPOE can be identified and overcome and the medication-use process associated with antineoplastic agents improved.

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Assessment of efficiency and safety of the comprehensive Chemotherapy Assistance Program for ordering oncology medications

Cited by 12 publications

References 44 publications

A Systematic Review of Clinical Decision Support Systems for Clinical Oncology Practice

A Systematic Review of Clinical Decision Support Systems for Clinical Oncology Practice

Safe Implementation of Computerized Provider Order Entry for Adult Oncology

The impact of a computerized physician order entry system on medical errors with antineoplastic drugs 5 years after its implementation

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