From the Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, MA; International and Commercial Services Division, University of Pittsburgh Medical Center, Pittsburgh, PA and Texas Oncology PA, Dallas, TX
Authors’ disclosures of potential conflicts of interest are found at the end of this article.
Address reprint requests to Lawrence N. Shulman, MD, Chief Medical Officer and Senior Vice President for Medical Affairs, Dana-Farber Cancer Institute, 44 Binney Street, Dana 1608, Boston, MA 02115; e-mail: Lawrence_Shulman{at}dfci.harvard.edu
Overview: Chemotherapy ordering, preparation, and administration are high-risk activities because of the toxic nature of chemotherapy agents and their small therapeutic windows. Small errors can result in significant patient morbidity and mortality. Electronic health records (EHRs) are being developed for oncology practices and are designed to integrate electronic medical records with chemotherapy order entry systems. Ideally, oncology EHRs will offer improved patient safety, clinical efficiency, and availability of medical information. However, it is critical to establish principles of safe practice that govern the design of the EHR, its functionality, and its integration with the clinical workflow of the practice. In fact, the evaluation of potential EHRs for a practice and the implementation of an EHR provide the opportunity to evaluate overall practice principles and to improve patient safety and clinical efficiency. Establishment of safe practice principles and an ideal workflow should be performed in an organized and multidisciplinary forum. In addition, measurement of quality metrics is becoming a more standard component of medical care in general and oncology care in particular. Routine quality assessment and quality improvement activities should be integrated into every practice.
