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Chemotherapy roadmaps in pediatric oncology: A digital electronic medical record integrated solution
Mary T Field1, Adam J Lamble1,2, Susan L Holtzclaw1
1Cancer and Blood Disorders Center, Seattle Children's Hospital, USA.
Background:
Delivery of antineoplastic regimens in the pediatric setting is facilitated by a paper roadmap. Paper roadmaps are the key safety tool required for safe ordering. Electronic medical record systems offer technological solutions for ordering antineoplastic regimens, however, do not offer a solution that integrates paper roadmaps digitally.
Methods:
A multidisciplinary project team implemented real-time clinician scanning of paper roadmaps into the electronic medical record.
Results:
The rate of missing roadmaps decreased from an average of 1.6 to 0.8 per week. Pharmacists gained 3 h of productivity daily. Providers spend an average of 35-45 s and a total of seven clicks each time a roadmap is scanned. Overall, the clinical systems analyst spent less than 1 h of total build time.
Conclusion:
Implementing roadmap scanning decreased the rate of missing roadmaps, increased pharmacist productivity, and required a nominal amount of analyst and provider time. In addition, this solution allows for concurrent viewing of the roadmap files from any connected computer, facilitating an easier co-signature process for providers, pharmacists, and nurses.
Practice Implications:
These results suggest that implementing real-time scanning of roadmaps can improve oncology care efficiency while maintaining the same safety rigor that paper roadmaps offer.
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