News

Press

Small mistakes, huge consequences; Onc-specific software improves safety

By Ron Piana
February 24, 2009

Source: CancerNetwork

BOSTON--In 1994, Betsy Lehman—a 39-year-old health columnist for the Boston Globe—was undergoing breast cancer treatment at Dana-Farber Cancer Institute. A doctor at the center read the handwritten chemotherapy order as 4 g/m2 per day, instead of 4 g/m2 spread over 4 days. Consequently, she received four times the intended dose for 4 consecutive days—a fatal overdose. Betsy Lehman’s death by medical error sent shockwaves throughout Dana-Farber, prompting, among other changes, adoption of an electronic chemotherapy order-entry system that red-flag’s discrepancies in chemo dosage.

Small market, idiosyncratic language

Although Dana-Farber and other IT-engaged institutions report a marked increase in efficiencies and safety outcomes, adoption of health IT by community oncologists remains sluggish. It’s not just tech-shy docs worried about start-up costs and office disruption. Major health IT players have also been slow to develop products for oncologists; the market is relatively small, and the language and workflow is more challenging to manage than most sub-specialties.

Fortunately, some vendors are developing systems that might persuade the oncology community to abandon error-prone paper-based calculations, such as IntelliDose, created by the Boston-based company, IntrinsiQ directly after the Dana-Farber tragedy. According to product manager, Andrew Scott, “IntelliDose is an oncology-specific software application that completely automates the order-entry, administration, and documentation process of delivering chemotherapy to cancer patients.”

Although IntelliDose is not a complete EMR, Mr. Scott pointed out “that 80% of the work a community oncologist does is about managing chemotherapy regimens. IntelliDose manages all of the daily workflow issues on one piece of software.” He said that the software creates efficiencies by relieving the burden placed on pharmacy and infusion nurses for double-checking calculations and interpreting handwriting.

A good place to start

One concern about adopting health IT in a stepwise process is modularity. According to Mr. Scott, IntelliDose has very tight interface and integration capabilities. “Once an office is up and running with IntelliDose and they make a move to a large EMR system, we basically just have to hook the applications together. We have a comprehensive set of inbound interfaces that simplifies the process,” said Mr. Scott.

IntelliDose can also be interfaced with hospital EMRs, labs, and pharmacies. Mr. Scott explained that the system verifies lab results, calculates drug doses, supports nurse charting, and allows physicians to write take-home prescriptions. “It also offers a charge capture feature and pulls demographic data from hospital- and office-based administrative systems,” added Mr. Scott.

Mr. Scott said that integrating IntelliDose into a practice is a one-step process that can be maximized by “using voice-activated transcription. And if the workflow involves mobile use, IntelliDose is flexible enough to operate on a laptop, tablet PC or desktop PC at a small one or two doctor practice or a large cancer network.”

But Mr. Scott emphasized that although IntelliDose increases office efficiencies, patient safety is paramount. “IntelliDose,” said Mr. Scott, “improves patient safety not only by automating the ordering process, but providing a central repository for tracking medications that have been administered to each patient.”