A new computerized system for chemotherapy patients promises to advance Beth Israel Deaconess Medical Center's patient safety effort by establishing automatic standards for all treatment plans.
“This is a major milestone,” said Larry Markson, MD, Director of Development, Information Systems, in discussing the addition of oncology to the medical center's computerized physician order entry (POE) system. “This adds quite a significant number of new safety features and benefits. The dosing calculations are automatic and the regimens are standardized.”
Most chemotherapy today is delivered on an outpatient basis, where the patient comes in for what can be many hours of treatment that includes not just the chemotherapy itself, but also a host of other medications, fluids and supportive therapies.
“What this system lets you do is go to a tab in [web-based online medical records] and see the complete history of doctor's orders,” said Markson. “The patient's oncology tab has a detailed history of everything ordered, when it was ordered, and what happened. Did the therapy treatment get delivered as ordered? Was it held? Was it partly delivered? Did the patient have an adverse reaction? That in itself, all online, is a big safety feature.”
Another important feature is that the system alerts the physician if an entry is made outside of the usual or standard range.
“The system will send an alert that this is a change from the usual,” said Markson. “We know that physicians will sometimes intentionally and appropriately order therapy that is outside the usual range. The idea behind alerts is to catch people from making mistakes unintentionally.”
Side by side with the chemotherapy orders, the system also displays all relevant labs and allows the physician, nurses, pharmacists and other health care workers to follow the patient through his or her workflow, from arrival, to looking at their vital statistics, when treatment occurs and if there were any adverse reactions.
“We've created a level of integration that you just don't see anywhere else,” said Markson.