Pasalic Dario, Reddy Jay P, Edwards Timothy, Pan Hubert Y, Smith Benjamin D
All authors: The University of Texas MD Anderson Cancer Center, Houston, TX.
JCO Clin Cancer Inform. 2018 Dec;2:1-12. doi: 10.1200/CCI.18.00034.
To describe the feasibility and benefits of implementing a custom radiation oncology electronic data capture (EDC) system in a large academic radiation oncology practice.
A Web-based point-and-click EDC known as Brocade was internally developed and implemented systemwide in 2016. Brocade captures key data elements, such as stage, histology, and patient and treatment characteristics; links this information to radiation dose data extracted from the record and verify system; and creates clinical notes that are automatically exported to the hospital electronic health record. We report the number of unique radiation episodes captured by Brocade in its first full year of implementation and describe the notes generated, toxicities captured, compliance with staging and quality assurance, and time of day in which documentation occurred with Brocade versus our prior human transcription system.
A median of 756 radiation episodes per month was captured for a total of 9,283 unique episodes captured in the first full year of implementation. The most common notes were for on-treatment visits (29,913) and simulations (13,220). Stage was captured for 92.2% of Brocade episodes (8,513 of 9,236) versus 29.7% of courses pre-Brocade (3,025 of 10,170; P < .001). Quality assurance was documented for 96.3% of completed courses (7,601 of 7,892). The most common grade ≥1 toxicities were pain (10,031), fatigue (7,490), and dermatitis (6,172). Brocade implementation was associated with a reduction in off-hours documentation and increase in the proportion of documentation created between 8:00 am and 12:00 pm.
Brocade is a reliable Web-based EDC tool that improves clinical documentation without detracting from clinical workflow. Moreover, Brocade has the advantage of capturing data in a structured manner that facilitates real-time analytics and outcome reporting.
描述在大型学术性放射肿瘤学实践中实施定制化放射肿瘤学电子数据采集（EDC）系统的可行性和益处。
2016年在全系统内部开发并实施了一种名为锦缎（Brocade）的基于网络的点击式EDC。锦缎采集关键数据元素，如分期、组织学以及患者和治疗特征；将这些信息与从记录和验证系统中提取的放射剂量数据相链接；并创建自动导出至医院电子健康记录的临床记录。我们报告锦缎在实施的首个完整年度中采集的独特放射治疗事件数量，并描述所生成的记录、所采集的毒性反应、分期和质量保证的依从情况，以及使用锦缎与我们之前的人工转录系统进行记录的时间。
在实施的首个完整年度中，每月采集的放射治疗事件中位数为756例，总共采集了9283例独特事件。最常见的记录是治疗期间就诊（29913条）和模拟（13220条）。锦缎记录的病例分期占92.2%（9236例中的8513例），而在锦缎系统使用前的疗程中这一比例为29.7%（10170例中的3025例；P <.001）。96.3%的完成疗程记录了质量保证情况（7892例中的7601例）。最常见的≥1级毒性反应是疼痛（10031例）、疲劳（7490例）和皮炎（6172例）。锦缎的实施与非工作时间记录的减少以及上午8:00至12:00之间创建记录的比例增加相关。
锦缎是一种可靠的基于网络的EDC工具，可改善临床记录且不影响临床工作流程。此外，锦缎具有以结构化方式采集数据的优势，便于进行实时分析和结果报告。
