First, the clinic needed an order entry system for the oncology pharmacists to enter the physician orders. The program needed to stop the pharmacist from entering an order for a drug to which the patient had an allergy, ensure that the order is written for the correct final concentration (chemotherapy drugs can extravasate and render the vein useless for further infusions if the concentration is not diluted enough), and check that all the ingredients are compatible with each other. The program also flags patients for whom there are no current lab values in the computer. If the patient’s lab values are not compatible with chemotherapy administration, the program will not allow orders for those drugs to be entered. The clinic provided our programmers with specific clinical information to incorporate into the program, which is used for the prospective analysis of each order. The program, with the proper maintenance by the pharmacy staff, will track maximum dose and lifetime doses of certain chemotherapy agents. Pharmacists are able to override any of the warning messages generated by the software, however the program maintains a database of those overrides.

Secondly, the clinic needed a way to generate patient charges for drugs ordered by the physician. The program is designed to print patient charges on a daily basis. This information can be printed and given to the patient accounting department or downloaded to the billing program.

Monographs for the commonly used drugs can be accessed and printed. The system maintains a formulary of drugs used in the clinic and can be accessed with the proper login.

The most important aspect is patient safety. With proper use of this program, errors due to allergy, drug interaction, maximum and lifetime dose, and concentration of final product are minimized.