Toward successful migration to computerized physician order entry for chemotherapy.

Area of Science:

• Oncology
• Health Informatics
• Patient Safety

Background:

• Computerized physician order entry (CPOE) systems enhance clinical order management and have demonstrated significant improvements in chemotherapy safety by reducing prescribing errors.
• System usability is a critical factor for the successful adoption of CPOE, yet literature on CPOE usability for chemotherapy and cancer care provider experiences is scarce.

Purpose of the Study:

• To assess the current status of CPOE adoption in Canadian oncology institutions.
• To identify and prioritize knowledge gaps concerning CPOE usability and adoption in cancer care.
• To establish a research agenda for improving CPOE implementation and usability.

Main Methods:

• A mixed-methods approach was employed, combining a national survey of cancer care providers across Canadian provinces with a workshop.
• The workshop included oncology clinicians, human factors engineers, patient safety researchers, policymakers, and hospital administrators from Canada and the United States.

Main Results:

• Key issues identified include a need for better understanding of chemotherapy ordering/preparation/administration practices, lack of guidance on system selection/procurement/implementation/maintenance, and poor CPOE usability and workflow support.
• Three major research themes emerged: investigating workflow variations, developing chemotherapy-specific CPOE procurement and implementation guidance, and measuring the effects of CPOE implementation in medical oncology.

Conclusions:

• Addressing CPOE usability and adoption challenges in chemotherapy requires future research.
• Focus areas for research include workflow variations, chemotherapy-specific CPOE procurement needs, and implementation guidance to accelerate successful CPOE migration for cancer care providers.