The Cerner Powerchart Oncology module is an integrated Oncology Information System for the Cerner Millenium platform that combines electronic chemotherapy prescription, communication, staging and documentation to improve safety, standardisation and data capture.
We describe the process by which the product was deployed within the Olivia Newton John Cancer Wellness and Research Centre (ONJCWRC), and the challenges in systems design, stakeholder buy-in, and launch.
The product was deployed at a metropolitan cancer centre servicing adult malignant haematology and oncology with a 30 chair infusion centre and busy inpatient ward service. The components deployed were: electronic regimens with days of treatment that with intermittent IV workflows for both inpatients and outpatients, clinical documentation for inpatients and outpatients, tumour staging modules, scheduling and ordering of non-chemotherapy related appointments using Cerner Scheduler, ordering of clinic appointments via Cerner, and a longitudinal chemotherapy management plan document. Integration with the third party patient administration (TRAKCare) and pharmacy dispensing (Merlin) was achieved. Cerner scheduling was not deployed within electronic regimens. The project go-live date was June 2018. Seventy regimens were released, with an estimate of approximately 220 required, excluding clinical trials.
Between 20/06/17 and 11/08/17 we have treated 240 patients with 548 cycles of chemotherapy, and 45/70 regimens have been prescribed. No significant errors have been recorded. Processes to audit dose modification data for quality improvement and develop/maintain electronic regimens have been developed.
Ongoing development is required to transition out of a hybrid paper-electronic chemo prescribing situation. Non-technical risks relate to hybrid documentation processes for medical teams consulting on oncology patients, and additional education is being instituted across the organisation to improve compliance.