title: Does applying technology throughout the medication use process improve patient safety with antineoplastics?
abstract: OBJECTIVE
  Medical errors, in particular medication errors, continue to be a troublesome factor in the delivery of safe and effective patient care. Antineoplastic agents represent a group of medications highly susceptible to medication errors due to their complex regimens and narrow therapeutic indices. As the majority of these medication errors are frequently associated with breakdowns in poorly defined systems, developing technologies and evolving workflows seem to be a logical approach to provide added safeguards against medication errors.
  
  
  CONCLUSIONS
  This article will review both the pros and cons of today's technologies and their ability to simplify the medication use process, reduce medication errors, improve documentation, improve healthcare costs and increase provider efficiency as relates to the use of antineoplastic therapy throughout the medication use process. Several technologies, mainly computerized provider order entry (CPOE), barcode medication administration (BCMA), smart pumps, electronic medication administration record (eMAR), and telepharmacy, have been well described and proven to reduce medication errors, improve adherence to quality metrics, and/or improve healthcare costs in a broad scope of patients. The utilization of these technologies during antineoplastic therapy is weak at best and lacking for most. Specific to the antineoplastic medication use system, the only technology with data to adequately support a claim of reduced medication errors is CPOE. In addition to the benefits these technologies can provide, it is also important to recognize their potential to induce new types of errors and inefficiencies which can negatively impact patient care.
  
  
  CONCLUSIONS
  The utilization of technology reduces but does not eliminate the potential for error. The evidence base to support technology in preventing medication errors is limited in general but even more deficient in the realm of antineoplastic therapy. Though CPOE has the best evidence to support its use in the antineoplastic population, benefit from many other technologies may have to be inferred based on data from other patient populations. As health systems begin to widely adopt and implement new technologies it is important to critically assess their effectiveness in improving patient safety.
authors.affiliation: Department of Pharmacy Services, Oregon Health & Science University, OR, USA bubaloj@ohsu.edu.
authors.forename: Joseph
authors.initials: J
authors.lastname: Bubalo
authors.affiliation: Department of Pharmacy Services, Oregon Health & Science University, OR, USA.
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Warden
authors.affiliation: Department of Pharmacy Services, Oregon Health & Science University, OR, USA.
authors.forename: Joshua J
authors.initials: JJ
authors.lastname: Wiegel
authors.affiliation: University of Washington Medical Center, WA, USA.
authors.forename: Tess
authors.initials: T
authors.lastname: Nishida
authors.affiliation: Department of Pharmacy Services, Roswell Park Cancer Institute, NY, USA.
authors.forename: Evelyn
authors.initials: E
authors.lastname: Handel
authors.affiliation: University of Virginia Health System, VA, USA.
authors.forename: Leanne M
authors.initials: LM
authors.lastname: Svoboda
authors.affiliation: Department of Pharmacy Services, Oregon Health & Science University, OR, USA.
authors.forename: Lam
authors.initials: L
authors.lastname: Nguyen
authors.affiliation: Department of Pharmacy Services, Oregon Health & Science University, OR, USA.
authors.forename: P Neil
authors.initials: PN
authors.lastname: Edillo
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D020811:Biomedical Technology / Q000379:methods*; D001330:Electronic Data Processing; D057286:Electronic Health Records; D006801:Humans; D050316:Medical Order Entry Systems; D008508:Medication Errors / Q000517:prevention & control*; D017216:Telemedicine / Q000379:methods; D057188:Workflow
chemical_list: D000970:Antineoplastic Agents
keywords: Technology; chemotherapy errors; patient safety