Authors (including presenting author) :
CHAN KLL(1), TSEUNG S(1), TANG PKK(2), POON PLP(3), CHAN WLF(1), LAM PKQ(3), YIP YTE(2), MAK WMV(1)
Affiliation :
(1) Division of Haematology and Haematological Oncology, Department of Medicine and Geriatrics, Princess Margaret Hospital
(2) Pharmacy, Princess Margaret Hospital
(3) Information Technology Division, Princess Margaret Hospital
Introduction :
Although in-patient medication order entry system (IPMOE) has been in place for years, challenges such as complexity of multi-agent regimens, frequent needs for dose adjustments and interruptions must be addressed before the chemotherapy module of the system can be widely implemented. Majority of chemotherapy prescriptions are still documented using paper-based medication administration records (MARs). The haematology day service of Princess Margaret Hospital was provided at the medical day ward, where chemotherapy MARs used to be ordered by faxing to the pharmacy. After administration, MARs were filed in a folder and stored in cabinets, which were transferred to outpatient clinic or wards in every appointment or hospitalisation. Drawbacks included paper consumption, occupation of storage place, and the risk of missing chemotherapy orders.
Objectives :
We aimed at assessing the effectiveness of the Electronic Chemotherapy Ordering System (ECOS), developed in March 2023 to replace fax and phone calls as the means of communication between pharmacy and haematology day service, and to save digital copies of chemotherapy MARs.
Methodology :
The chemotherapy ordering process with ECOS from January to December 2024 was reviewed retrospectively. ECOS features both desktop and mobile tablet app interfaces. Operation began by entering a unique patient identifier after admission. The camera function of mobile tablets was used to scan and upload documents, including paper-format MARs and invoices for self-financed items. Pharmacy staff used ECOS to acknowledge orders, request amendments and inform on vetting status. MARs were uploaded into ECOS rather than filed in the chemotherapy folder after drug administration.
Result & Outcome :
More than 4,800 chemotherapy orders were processed by ECOS in the study period. Facsimile was used on two days because of document scanning failures. There were no reports of missing chemotherapy orders conducted via ECOS. The system enabled all staff concerned to check the real-time order status, streamlining workflow and enhancing teamwork in ways which were not possible in the past. Remote access of past treatment records was also feasible with ECOS, and traditional chemotherapy folders will phased out completely after implementation of ECOS for inpatients.
Although ECOS cannot completely digitalise the ordering process, it is an effective interim solution before the implementation of IPMOE chemotherapy module. Its documentation function will be beneficial in long run, allowing for easy reference to treatment trajectories.
