title: Creating a process to standardize regimen order sets within an electronic health record.
abstract: OBJECTIVE
  US Oncology uses regimen order sets in clinical practice to treat patients. However, the process to assure accuracy and upkeep of these order sets has not been described. The purpose of this project was to evaluate the regimens housed in the electronic health record, iKnowMed, to determine their appropriateness and accuracy.
  
  
  METHODS
  US Oncology conducted an audit of its standardized regimen library. A utilization review compared chemotherapy regimens in the library and consolidated order sets on the basis of past utilization. Next, internal and external clinical pharmacists were contracted to verify the accuracy, dose, duration, and cycle length of regimens. References cited in the regimen library were evaluated. New or updated references or clinical practice standards were added or modified when necessary. US Oncology corporate pharmacists reviewed the recommendations and discussed findings with an oversight committee. Final proposals were voted on before being incorporated into iKnowMed. An internal database tracking system tool for all reviewed recommendations was created to track and communicate needed changes to the electronic health record.
  
  
  RESULTS
  Out of 511 regimen order sets, 51 were recommended for removal or consolidation. Of the remaining 460 regimen order sets, all had some administrative changes. Specifically, 75% had title changes, 14% had cycle-related changes, 31% had reference updates, and 13% had dosing updates.
  
  
  CONCLUSIONS
  Electronic health records systems, such as iKnowMed, can provide standardized order sets for a large oncology network. However, the regimens need to be evaluated routinely using standardized procedures to ensure they are accurate and current.
authors: US Oncology, The Woodlands, TX.
authors: Leslie T
authors: LT
authors: Busby
authors: Sheetal
authors: S
authors: Sheth
authors: Jody
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authors: Garey
authors: Aimee
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authors: Ginsburg
authors: Thomas
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authors: Flynn
authors: Michael A
authors: MA
authors: Willen
authors: Scott
authors: S
authors: Kruger
authors: Marcus A
authors: MA
authors: Neubauer
authors: Michael
authors: M
authors: Kolodziej
authors: David
authors: D
authors: Chang
authors: Eric Scott
authors: ES
authors: Palmer
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authors: McGuinness
authors: Nancy J
authors: NJ
authors: Egerton
authors: Jan
authors: J
authors: Merriman
authors: Eileen B
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authors: Herbeck
authors: Alison
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authors: Fetter
authors: Linda
authors: L
authors: Frisk
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authors: Sitarik
authors: Roger
authors: R
authors: Anderson
authors: Roy
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authors: Beveridge