Conversion from paper to electronic acute care chemotherapy orders.
PURPOSE
UNC Medical Center converted to an electronic health record (EHR) in 2014. This conversion allowed for the transition of paper chemotherapy orders to be managed electronically. This article describes the process for converting inpatient paper chemotherapy orders into the new EHR in a safe and effective manner.


SUMMARY
A collaborative interdisciplinary approach to the EHR transition enabled our organization to move from using paper chemotherapy orders to fully electronic chemotherapy treatment plans in both ambulatory and acute care areas. Active chemotherapy orders for acute care inpatients were reviewed and transcribed by two oncology pharmacists in the cancer hospital prior to being signed by an attending physician. The newly input orders were independently verified by two pharmacists in the cancer hospital inpatient pharmacy. Nurse review of the signed and verified treatment plans, along with reconciliation of the medication administration record ensured a safe transition to the new EHR workflow. Providers benefit from the ability to review treatment plans remotely, track changes, and include supportive medications in one consolidated location. The coordinated team effort allowed for a smooth transition with minimal interruptions to patient care.


CONCLUSION
The pharmacist-led, multidisciplinary conversion to electronic chemotherapy orders was safe, accurate, and occurred ahead of schedule for the EHR go-live. Advance communication and planning around scheduled inpatient admissions helped to minimize the impact of the transition from paper to electronic treatment plans. Both pharmacist and physician engagement were necessary to ensure a smooth transition for active inpatient treatment plans.
['Offei-Nkansah|Gerald|G|', 'Amerine|Lindsey B|LB|']
D000970:Antineoplastic Agents D002173:Cancer Care Facilities D057286:Electronic Health Records D006801:Humans D007297:Inpatients D059065:Medication Reconciliation D010348:Patient Care Team D010595:Pharmacists D010607:Pharmacy Service, Hospital D010820:Physicians D024382:Professional Role D057188:Workflow
electronic health record cancer hospital hospital clinical pharmacy clinical pharmacy service computerized medical record drug therapy electronic medical record information systems oncology service pharmacy service