by Kurt Knaub, Carrie Carson

Challenge

For major oncology centers, implementing an electronic medical record (EMR) system brings the unique challenges of accommodating complex chemotherapy regimens and highly specialized therapies such as bone marrow transplant protocols. For a world-renowned cancer treatment center, the goal to meet both clinical and research requirements added another magnitude of complexity, making its new EMR implementation all the more ambitious and leading-edge. They engaged Point B to lead its EMR implementation, including Computerized Physician Order Entry (CPOE).

Understanding complexity

We entered the project with four major challenges: configuring and customizing an EMR that could accommodate unique and complex oncology business requirements such as the “Day 0” regimen of a bone marrow transplant patient; building a customized scheduling application to bridge the different applications being used for its clinical and practice management systems; building hundreds of order sets for a large, fluid research base; and educating staff on new and very complex workflows.

For this engagement, Point B took on the “business architect” role that a system vendor might ordinarily fill. Understanding the unique demands of oncology treatment and research was critical every step of the way.

Working closely with key clinical stakeholders, we led a series of iterative design sessions to capture and translate the center’s technical and business requirements into an integrated solution that addressed the entire organization’s needs. Those needs include both inpatient and outpatient treatment as well as research activities.

Putting clinical adoption first

The original EMR plan doubled typical EMR clinical adoption efforts and still underestimated the need for clinical adoption efforts critical to success, especially given the complexities of the system and the practice of oncology. In order to ensure successful adoption, the Point B team pushed back the go-live date, reworked the software development cycle and moved training far up in the cycle. This gave staff additional months to train and apply what they’d learned in real-life scenarios. It also allowed us to further  customize training scenarios with workflow specific order sets into the system so users could walk through every one of their own specific steps many times, rather than train on general functionalities they would have to customize later on. We also addressed the training needs of research staff to get, and stay, up to speed on the system when they may use it only a few hours a week.

Advancing breakthrough work

Launching CPOE put our client’s EMR in a league with its leading cancer treatment and research—advancing our client’s goal, every day, “to turn cancer patients into cancer survivors.”