Hill-Kayser Christine E, Jacobs Linda A, Gabriel Peter, Palmer Steven C, Hampshire Margaret K, Vachani Carolyn, Edge Stephen B, Metz James M
University of Pennsylvania Abramson Cancer Center, Philadelphia, Pennsylvania; and Baptist Memorial Cancer Center, Memphis, Tennessee
University of Pennsylvania Abramson Cancer Center, Philadelphia, Pennsylvania; and Baptist Memorial Cancer Center, Memphis, Tennessee.
J Oncol Pract. 2016 Apr;12(4):e380-7. doi: 10.1200/JOP.2015.006841. Epub 2016 Mar 22.
Survivorship care plans (SCPs) are recommended for all cancer survivors. Myriad barriers to implementation exist. This study was performed to evaluate the feasibility of interface development between an SCP and an electronic medical record (EMR).
An information technology application was developed to extract data from the EMR in use at our center (Epic). Data were transferred to autopopulate an Internet-based tool for creation of SCPs (LIVESTRONG Care Plan) that had been previously used for the creation of more than 35,000 plans.
Data (demographic characteristics, surgeries, chemotherapy drugs, radiation site) were extracted from the EMR and transferred to the care plan platform, without transfer of protected health information. Care plans were created and transferred back to the EMR. During clinical testing, SCPs were created by nurse practitioners during scheduled clinic visits for 146 sequential, eligible patients (67% breast cancer, 33% colorectal cancer). All patients received completed care for a single cancer diagnosis at our institution. All data points that were automatically populated were reviewed by practitioners, and missing/blank data fields were populated manually when necessary. Data entered into generated care plans were accurate in 97% of audited cases, and the process of care plan generation could be completed in < 1 minute.
This is a feasible solution for the autopopulation of SCPs from the EMR. It represents a future methodology through which widespread implementation of SCPs may be undertaken. Future directions include further clinical testing, assessment of provider-perceived usefulness, and integration into routine clinical care.
建议为所有癌症幸存者制定生存护理计划（SCP）。实施过程中存在诸多障碍。本研究旨在评估SCP与电子病历（EMR）之间接口开发的可行性。
开发了一种信息技术应用程序，用于从我们中心使用的电子病历（Epic）中提取数据。数据被传输以自动填充一个基于互联网的SCP创建工具（LIVESTRONG护理计划），该工具此前已用于创建超过35000份计划。
从电子病历中提取数据（人口统计学特征、手术、化疗药物、放疗部位）并传输到护理计划平台，同时不传输受保护的健康信息。创建护理计划并将其传输回电子病历。在临床测试期间，执业护士在预定的门诊就诊时为146例连续符合条件的患者（67%为乳腺癌，33%为结直肠癌）创建了SCP。所有患者均在我们机构接受了针对单一癌症诊断的完整护理。所有自动填充的数据点均由执业人员进行审核，必要时手动填充缺失/空白数据字段。在97%的审核病例中，输入生成的护理计划中的数据准确无误，护理计划生成过程可在不到1分钟内完成。
这是一种从电子病历自动填充SCP的可行解决方案。它代表了一种未来的方法，通过该方法可以广泛实施SCP。未来的方向包括进一步临床测试、评估提供者感知的有用性以及整合到常规临床护理中。
