The use of a novel clinical decision support system for reducing medication errors and expediting care in the provision of chemotherapy

Background The clinical use of software, specifically clinical decision support systems (CDSS) coupled with computerized provider order entry (CPOE) systems (CPOE/CDSS), has strong potential to improve chemotherapy treatment. Objective The aim of this observational study was to evaluate whether the use of a CPOE/CDSS in chemotherapy treatment can improve dosing accuracy and/or expedite the patient intake process. Setting/Method We conducted a month-long pilot implementation of a proprietary CPOE/CDSS called CenseoRx® at a large hospital in Athens, Greece. Anonymized chemotherapy dosage data, patient intake time, and time to log laboratory exams were recorded from 58 subjects. Main outcome measure The therapeutic dosing decisions of physicians and of the software were compared. The time required to admit a new patient and the time required to log laboratory exams were recorded on the first and last week of the study period and compared. Results A significant difference between the doctor-prescribed and the CPOE/CDSS-recommended dosage of the chemotherapeutic agents was observed for medications requiring body surface area (BSA)-based dosing, area under the curve (AUC)-based dosing, or weight-based dosing [mean difference = 18.42 mg chemotherapeutic agent, p = 0.0040] and for medications requiring solely AUC-based dosing [mean difference = 95.62 mg chemotherapeutic agent, p = 0.0295], with doctors under-prescribing the chemotherapeutic drug as compared to the CPOE/CDSS. A significant decrease in time needed for patient intake and for logging laboratory results was observed over the study period [mean difference = 121.5 s; mean difference = 89.0 s, respectively]. Conclusions The implementation of a CPOE/CDSS can enhance the safety and quality of chemotherapy treatment.