title: Evaluation and implementation of chemotherapy regimen validation in an electronic health record.
abstract: BACKGROUND
  Computerized provider order entry of chemotherapy regimens is quickly becoming the standard for prescribing chemotherapy in both inpatient and ambulatory settings. One of the difficulties with implementation of chemotherapy regimen computerized provider order entry lies in verifying the accuracy and completeness of all regimens built in the system library. Our goal was to develop, implement, and evaluate a process for validating chemotherapy regimens in an electronic health record.
  
  
  METHODS
  We describe our experience developing and implementing a process for validating chemotherapy regimens in the setting of a standard, commercially available computerized provider order entry system. The pilot project focused on validating chemotherapy regimens in the adult inpatient oncology setting and adult ambulatory hematologic malignancy setting.
  
  
  RESULTS
  A chemotherapy regimen validation process was defined as a result of the pilot project. Over a 27-week pilot period, 32 chemotherapy regimens were validated using the process we developed. Results of the study suggest that by validating chemotherapy regimens, the amount of time spent by pharmacists in daily chemotherapy review was decreased. In addition, the number of pharmacist modifications required to make regimens complete and accurate were decreased. Both physician and pharmacy disciplines showed improved satisfaction and confidence levels with chemotherapy regimens after implementation of the validation system.
  
  
  CONCLUSIONS
  Chemotherapy regimen validation required a considerable amount of planning and time but resulted in increased pharmacist efficiency and improved provider confidence and satisfaction.
authors: Oregon Health and Science University Hospital, Portland, OR, USA diazam@ohsu.edu.
authors: Amber H
authors: AH
authors: Diaz
authors: Oregon Health and Science University Hospital, Portland, OR, USA.
authors: Joseph S
authors: JS
authors: Bubalo
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000458:organization & administration; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D057286:Electronic Health Records; D006801:Humans; D007297:Inpatients; D050316:Medical Order Entry Systems; D008508:Medication Errors / Q000517:prevention & control; D010593:Pharmaceutical Services / Q000458:organization & administration; D010595:Pharmacists / Q000458:organization & administration; D010820:Physicians / Q000458:organization & administration; D010865:Pilot Projects; D010818:Practice Patterns, Physicians' / Q000592:standards*; D013997:Time Factors
chemical_list: D000970:Antineoplastic Agents
keywords: Chemotherapy regimen; chemotherapy safety; electronic record; validation