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Effect of Transition to Electronic Medical Record Implementation in the Clinic

P Sansourekidou

P Sansourekidou*, D Pavord, M McLoughlin, Health Quest, Poughkeepsie, NY

SU-E-P-4 Sunday 3:00PM - 6:00PM Room: Exhibit Hall

In 2011, the department utilized paper charts and used MOSAIQ (Elekta AB) as Record and Verify and document repository. In 2012 MOSAIQ was used as a full Electronic Medical Record. The progression to electronic charting was gradual for technical staff over a period of approximately 4 months, and non-gradual for clinical staff. The department went fully electronic in January 2012. Errors were tracked throughout this time period to estimate the impact.
An error is defined as an action that did not fully comply with the policy and procedure in effect at the time. In 2011, error reporting was available for technical staff in the form of weekly spreadsheet entry during weekly checks from physicists, dosimetrists, and radiation therapists. 2011 data is not available for clinical staff. Error reporting changed to a web-based tracking system in 2012 and included all staff.
For 2011, 77.3% were attributed to radiation therapists, 9.9% to radiation oncologists, 6% to physicists, 4.8 to dosimetrists and 2% other or unknown. The maximum appeared approximately 6 weeks before the physical removal of the treatment card and coincides with the rollout of policy and procedure changes. For 2012, 45.4% were attributed to radiation therapists, 10.7% to radiation oncologists, 12.1% to physicists, 20.0% to dosimetrists, 6.4% to clerical, 4.4% to nursing and 1% other or unknown. Errors related to treatment peaked 2 weeks after removal of physical chart. Total errors peak 3.2 months after removal of physical chart. Second peak coincides with another wave of policy changes implemented for Electronic Health Records compliance attestation.
Removal of the physical chart has a profound effect on the clinic. Technical staff handled electronic transition better than clinical/clerical staff. This is believed to be due to the gradual implementation. Errors stabilized after 6 months of electronic chart usage.

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