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Creating a process to standardize regimen order sets within an electronic health record
Leslie T Busby1, Sheetal Sheth, Jody Garey
1US Oncology, The Woodlands, TX.
Journal of Oncology Practice
|November 2, 2011
Summary
A review of US Oncology's electronic health record regimens found that while electronic health records (EHRs) standardize care, routine audits are essential for ensuring chemotherapy regimen accuracy and clinical relevance.
Area of Science:
- Oncology
- Health Informatics
- Clinical Pharmacy
Background:
- US Oncology utilizes standardized regimen order sets within its clinical practice for patient treatment.
- The established processes for ensuring the accuracy and maintenance of these order sets were not previously documented.
Purpose of the Study:
- To evaluate the appropriateness and accuracy of chemotherapy regimens within the iKnowMed electronic health record (EHR) system.
- To establish a standardized procedure for the ongoing assessment of EHR-housed regimens.
Main Methods:
- A comprehensive audit of the standardized regimen library was performed by US Oncology.
- Clinical pharmacists conducted a utilization review and verified regimen details (dose, duration, cycle length).
- References were evaluated, and updates were incorporated based on current clinical practice standards.
Main Results:
- Out of 511 regimen order sets, 51 were recommended for removal or consolidation.
- All remaining 460 regimen order sets required administrative modifications, including title changes (75%), cycle adjustments (14%), reference updates (31%), and dosing modifications (13%).
Conclusions:
- Electronic health record systems like iKnowMed can facilitate standardized oncology care across large networks.
- Regular evaluation of EHR regimens using standardized procedures is critical for maintaining accuracy and currency.
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