Concordance with best-practice guidelines for systemic treatment computerized prescriber order entry systems.
245 Background: In 2012, Cancer Care Ontario, released evidence-based guidance for the key features, functionalities, and components of a Systemic Treatment Computerized Prescriber Order Entry (ST CPOE) system to ensure safe, high-quality care. Concordance measurement indicators were developed alongside the guidelines and a survey was then conducted to understand the current state in a meaningful and practical manner in the province of Ontario. Methods: A self-assessment survey was distributed to 22 hospital groups, including cancer centres and both academic and community hospitals, using four different ST CPOE systems in Ontario. 52 items were assessed on a four-point Likert scale, and descriptive hospital data was collected. Composite scores were calculated by category (regimen and protocols, functionality, useful alerts, audit logs, system integration, usability) and overall. Local and provincial results were analyzed. Results: Twenty-one (21) responses were received, with the majority (17) of surveys being completed by pharmacists. 48% had been using a ST CPOE system for more than 5 years and 38% for less than one year. 81% responded that they did not, or did not know if, they had local/institutional indicators for monitoring their systems. The mean total concordance score overall was 79% (range 65% to 92%) of a potential 208 total points. The highest mean score was in the category of audit logs (92%) and the lowest in system integration (69%). Approximately half (48%) had a multidisciplinary ST CPOE advisory group. While 16 hospitals were using the same ST CPOE system, there was distinct variability in responses from these sites, indicating the effects of tailored implementations and/or discrepancy in level of knowledge of system functionalities. Conclusions: Current concordance with best practice guidelines for ST CPOE systems in Ontario is incomplete and variable. While ST CPOE systems have potential to improve safety in the chemotherapy delivery, differences in system functionalities and their implementation have been identified. This study will be used to inform specific areas of strength, set benchmarks and potential areas for improvement.