title: Integrated information systems for electronic chemotherapy medication administration.
abstract: BACKGROUND
  Chemotherapy administration is a highly complex and distributed task in both the inpatient and outpatient infusion center settings. The American Society of Clinical Oncology and the Oncology Nursing Society (ASCO/ONS) have developed standards that specify procedures and documentation requirements for safe chemotherapy administration. Yet paper-based approaches to medication administration have several disadvantages and do not provide any decision support for patient safety checks. Electronic medication administration that includes bar coding technology may provide additional safety checks, enable consistent documentation structure, and have additional downstream benefits.
  
  
  METHODS
  We describe the specialized configuration of clinical informatics systems for electronic chemotherapy medication administration. The system integrates the patient registration system, the inpatient order entry system, the pharmacy information system, the nursing documentation system, and the electronic health record.
  
  
  RESULTS
  We describe the process of deploying this infrastructure in the adult and pediatric inpatient oncology, hematology, and bone marrow transplant wards at Vanderbilt University Medical Center. We have successfully adapted the system for the oncology-specific documentation requirements detailed in the ASCO/ONS guidelines for chemotherapy administration. However, several limitations remain with regard to recording the day of treatment and dose number.
  
  
  CONCLUSIONS
  Overall, the configured systems facilitate compliance with the ASCO/ONS guidelines and improve the consistency of documentation and multidisciplinary team communication. Our success has prompted us to deploy this infrastructure in our outpatient chemotherapy infusion centers, a process that is currently underway and that will require a few unique considerations.
authors: Department of Biomedical Informatics, Department of Medicine, Division of Hematology and Oncology, Department of Nursing Services, and Informatics Center-Informatics Clinical Systems Department, Vanderbilt University School of Medicine, Nashville, TN.
authors: Mia A
authors: MA
authors: Levy
authors: Dario A
authors: DA
authors: Giuse
authors: Carol
authors: C
authors: Eck
authors: Gwen
authors: G
authors: Holder
authors: Giles
authors: G
authors: Lippard
authors: Julia
authors: J
authors: Cartwright
authors: Nancy K
authors: NK
authors: Rudge