Electronic Chemotherapy Order Entry: A Major Cancer Center's Implementation.

Area of Science:

• Oncology
• Health Informatics
• Clinical Systems Engineering

Background:

• Computerized provider order entry (CPOE) systems are crucial for medication safety and efficiency in cancer care.
• Implementing CPOE for complex chemotherapy regimens presents unique challenges due to regimen variability and toxicity.
• Existing paper-based chemotherapy ordering processes require careful translation to electronic systems.

Purpose of the Study:

• To describe the institutional efforts, challenges, and collaborative processes involved in implementing a universal computerized provider order entry system for complex chemotherapy regimens.
• To outline the strategies used to ensure the new electronic system mirrored established workflows while incorporating enhanced functionality.
• To detail the multi-year project involving a multidisciplinary team and vendor collaboration.

Main Methods:

• Formation of a multidisciplinary team comprising clinical and systems experts.
• Design of online tools to replicate existing paper forms and established chemotherapy processes.
• Phased implementation across multiple sites over several years.
• Close collaboration between the cancer center and the CPOE system vendor.

Main Results:

• Successful universal adoption of the computerized provider order entry system for complex chemotherapy regimens.
• Integration of new functionalities alongside the replication of successful paper-based processes.
• Demonstration of effective collaboration between clinical teams, IT experts, and external vendors.
• Overcoming challenges related to system design, user adoption, and multi-site deployment.

Conclusions:

• The implementation of a CPOE system for complex chemotherapy is feasible and requires extensive multidisciplinary collaboration.
• Careful system design that respects existing workflows while adding value is key to successful adoption.
• Strong institutional commitment and vendor partnership are essential for large-scale CPOE implementation in oncology.
• This initiative facilitated standardized and safer chemotherapy ordering across multiple clinical sites.