327 Background: Selection of an ideal EMR is an important but a complicated process, especially because there are few established guidelines available. We describe a case study on the process of selection of medical oncology EMR from our experience at St. Joseph Regional Cancer Center, Lewiston ID. Methods: A multidisciplinary team was developed, including a medical oncologist to develop workflow diagrams capturing tasks completed for patient care. This allowed the team to identify requirements and functionality important to have within an EMR. Requirements rating as high, medium or low. The scoring methodology was based on a rating scale (0-5, where 0 does not meet the fundamental requirement and 5 fully meets the fundamental requirement; 0-2, where 0 does not meet the differentiator requirement and 2 fully meets the differentiator requirement) to capture if system met fundamental and differentiator requirements. The team developed a list of the ten most important needs within a system to focus on while viewing vendor demos. The top 10 requirements focused on lab result integration, other facility integration, alerts, billing flow of information, electronic prescriptions, local assessments, electronic consent forms, flexibility in chemo calculations, sign-offs of treatments throughout the patient flow process, and the ability to order cycles of treatment in a multi-visit treatment plan. Finally, use case scenarios were developed and vendors were given the opportunity to demo their product using workflow scenarios. Results: Out of 10 medical oncology systems in consideration, the evaluation included four 3rd party vendor systems and one EMR platform system. Four systems were chosen for evaluation based on rankings from the 2011 Oncology IS KLAS report. Complete evaluation of the systems and the scorings were based on vendor demo webinars and multidisciplinary input. This methodical approach allowed the team to gain a broad, balanced approach in narrowing the search down to the top three finalists. Conclusions: A systematic approach that includes an objective scoring system and research by interviewing other sites is useful in selection of a medical oncology EMR.
The three paradoxes of patient flow: an explanatory case study
