Feature | September 09, 2011 | Helen Kuhl

OIS: Efficiency and Accessibility Are Key Factors

This article appeared as the introduction to a chart on oncology information systems in the September 2011 issue.

Radiation oncologists and most clinicians involved in the field prefer to spend their time treating patients, not sitting in front of a computer. Yet today more than ever, they are being tasked with spending precious time entering data and maintaining patient records. So the challenge arises for developers of software, like oncology information systems to make the process as painless and quick as possible for them. As a result, oncology information system (OIS) vendors are working hard to make improvements in that area.

“Time is of the essence to physicians,” said J.R. Munini, Varian Medical Systems’ product manager for its Aria system, during the recent meeting of the American Association of Physicists in Medicine (AAPM).  Improving workflow was one of Varian’s key goals in developing its Version 11 of Aria, which will be available in early 2012, he added.

Among its features will be a workflow management component intended to make the system more user-friendly. It is designed to make information readily accessible to clinicians, as well as to prompt them about the tasks they need to perform, “so they don’t have to remember everything themselves,” Munini said. “Version 11 will help them work smarter and more efficiently.”

Streamlined workflow also was cited as an important part of an OIS system by Elekta’s Alex Hill during the AAPM meeting. Elekta offers the Mosaiq OIS. Hill said that one of the key trends he sees in OI systems is an increased focus on safety features. But they have to be incorporated in a way that will not disrupt workflow, he noted.

“We want to add additional safety checks — features like reading an RFID tag to make sure the correct patient is getting the correct machine setup and doublechecking patient verifications in a lot of different ways,” he said. “But we must preserve and enhance workflow.”

Accessibility and Meaningful Use
The emergence of mobile solutions is another current trend that is affecting OIS, Hill said. “We are looking for any way to make the OIS and electronic medical record (EMR) accessible to as many people as possible.”  

That accessibility includes images, Hill added. “We are always trying to improve by providing access to all images that exist —  and quickly.”

Although oncology information systems are only one element, both Hill and Munini noted that there is a great deal of interest among customers about meaningful use (MU), especially with the approach of the Oct. 3, 2011 deadline, when healthcare providers have to start their 90-day period for compiling data.

Hill said many customers are asking how to set up their EMRs in order to get the information required for MU. “It’s a daunting task,” he said.

Munini said when it comes to MU, many people are unsure about what to do; they may think they are capturing the necessary data, but it might not be in the way it has to be presented. “People now realize there is a lot to it,” he said.

Aria Version 11 for EMR and clinical practice management in radiation oncology recently was certified, so that clinics can use it to qualify for the federal funding tied to MU. Other vendors are working to have their systems certified as well.

Attitude and Approach Important for Success in OIS Adoption
Ultimately, how useful an OIS becomes for an organization may have as much to do with the facility’s attitude and approach to using it as it does to the system itself — at least according to a study conducted a couple of years ago at two public hospitals in Sydney, Australia, and reported in the International Journal of Medical Informatics last year.[1] The study was conducted to gain knowledge to help guide the  introduction of OIS into public hospitals.

Clinicians at the two hospitals used the same OIS. Twelve of 15 radiation oncologists employed at the hospitals were interviewed, as well as personnel involved in the decision-making process for introduction of the system. From the interviews, information emerged regarding implementation strategies and practices and the radiation oncologists’ use and satisfaction with the OIS.

The study found the two hospitals had contrasting experiences. One used the OIS in all aspects of clinical documentation. Its implementation was associated with strong advocacy by the department head, input by a designated project manager, and use and development of the system by all staff, with timely training and support.

On the other hand, the second hospital had no vision of developing a paperless information system and used the OIS only for booking and patient tracking. Data entry was designated to administrative staff, which distanced clinicians from the system.

It was the study’s conclusion that critical factors for the successful introduction of an information system into a hospital environment were an initial clear vision to be paperless, strong clinical leadership and management at the departmental level, committed project management, and involvement of all staff, with appropriate training.

The clinicians interviewed also said an OIS should continuously evolve to meet changing clinical needs and departmental quality improvement initiatives. The study concluded that clinician engagement is essential for post-adoption evolution.

1 Yu P, Gandhidasan S, Miller AA. “Different usage of the same oncology information system in two hospitals in Sydney - lessons go beyond the initial introduction.” Int J Med Inform. June 2010; 79(6):422-9.

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