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Evaluating the Efficacy of a Safety Net Built for An Automated, Script-Driven RadOnc EMR

R Sheu

R Sheu*, A Powers , T Tseng , Y Lo , Mount Sinai Medical Center, New York, NY


MO-RPM-GePD-T-5 (Monday, July 31, 2017) 3:45 PM - 4:15 PM Room: Therapy ePoster Lounge

Purpose: To investigate the effectiveness of the in-house software system built to ensure EMR workflow safety and efficiency.

Methods: Rather than depending solely on automated, script-driven workflow QCL in MOSAIQ, an event-driven dashboard was developed to actively monitor clinical workflow and serve as a safety net for our EMR. In the beginning of 2016, an automated, daily email broadcast was also developed to notify team members of any outstanding items. The deficiencies and elapsed time for three types of time-sensitive routine physics checks (initial treatment check, weekly chart check, end-of-treatment check) were studied from Oct 2013, when the EMR went live, to the present, in order to assess the effectiveness of these tools.

Results: The deficiency rate for initial treatment checks, was 1.2% (57 out of 4562 sites) for the past 4 years, but dropped to 0.64% in 2016 when the auto-email system was implemented. Over 97% of initial treatment checks were performed on the first day of treatment, despite 5% of QCL’s being generated one day later. In 2016, 0.87% (8 of 1191 treatment sites) of QCL’s requesting initial checks were missed by staff, but only 0.33% deficiencies resulted. These extraordinarily low numbers demonstrate the effectiveness of the automated email system in actively monitoring and notifying staff. The combined system reduced EOT check deficiencies from 3.3% to 2.6%. The average weekly check deficiency rate dropped from 0.9% to 0.5% after the daily monitoring and email notifications were implemented.

Conclusion: Our active monitoring system has significantly improved our EMR environment. The system not only serves as the safety net to reduce deficiencies and errors, but also provides valuable information to improve safety and efficiency. Periodic evaluation of deficiencies and continuous improvement of the monitoring system is the key to achieve an error free and safe EMR environment.

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