Lindsay Dozeman1, Thomas Feldman2, Allyson Schultz3,. Annick Tricot3. 1 Internal Medicine ... CIBMTR's Pre-TED layout. Abstracts / Biol Blood Marrow ...
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Figure 2. Hover tips guide show users commonly associated diseases per CIBMTR’s Pre-TED layout.
database. We then imported the CTCAE from a spreadsheet into drop down menus to decrease the likelihood of entry errors and to standardize the data at the time of first entry. As we reviewed the documentation in EpicÒ, it became clear that a lack of standardized terminology made it difficult for the consistent and accurate documentation of this data within the medical records. Since our project began in the spring of 2014, our Senior
Figure 3. The Help Portal assists users with reporting guides and automated emails for questions.
Figure 4. The split screen allows users to view multiple transplants for the same recipient. The user can switch between transplants to assure cytogenetics and molecular markers data are consistent.
437 Addressing the Need for Standardized Adverse Event (AE) Documentation within the Electronic Medical Record (EMR): Part 2 Lindsay Dozeman1, Thomas Feldman2, Allyson Schultz3, Annick Tricot3. 1 Internal Medicine, Division of Hematology, Oncology, and Blood and Marrow Transplantation, University of Iowa Hospitals and Clinics, Iowa City, IA; 2 The University of Iowa Hospitals and Clinics, Iowa City, IA; 3 Clinical Trials Support Core, University of Iowa Hospitals, Iowa City, IA Background: Accurate reporting of adverse events (AEs) facilitates analyses of new and approved therapies and is a federal requirement for clinical research. Healthcare professionals utilize the Common Terminology Criteria for Adverse Events (CTCAE) for this reporting. Our group reviewed the documentation within our hospital’s EMR EpicÒ for a subset of over 100 transplants performed in 2012-2013 and collected data for toxicities meeting grades 3 or higher into a shared projectspecific AccessÒ database which is tied to the program BMT
Application Developer worked with EpicÒ to integrate the CTCAE within our hospital’s EMR. The University of Iowa imported from EpicÒ the CTCAE Toxicity Assessment V4.03 into our EMR. This charting was made available for physicians to document. Our program now has the ability to document toxicities into a dynamic and user-friendly template. This discrete data is able to display to our physicians and staff in real time and able to export out for data analysis. The BMT program also has the ability to run reports on documented toxicities with ease and save as a XML file, thereby saving staff time and resources by eliminating the requirement for other team members to reenter each record and search to abstract this important data. Since starting with V4.03 we have created charting options for V4.01 and V4.02 by request of staff. All this charting will be available to document by BMT and all our oncology physicians. After an extensive analysis by our team, it was determined that an additional tool could further support clinician documentation when they are away from the hospital EMR system. Our Clinical Trials Research Specialist came up with
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an idea for the capture of toxicities by which clinicians would answer a series of yes or no questions that would produce the appropriate toxicity via smartphone or tablet. Conclusion: As a result of our experience with our data project, current efforts are underway to enhance and support the documentation of toxicities related to transplantation. By making the entry of this data efficient and available in multiple platforms, we are confident that clinicians and program staff will find the documentation and analysis of this critical data more accessible and usable than ever before.
438 The Process of Choosing the Best Match for BMT Informatics Software Nicolette Maria Minas 1, Kathleen Ruehle 2. 1 Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore, MD; 2 Greenebaum Cancer Center Blood and Marrow Transplant Unit, University of Maryland Medical Center, Baltimore, MD Background: The University of Maryland Medical Center Blood and Marrow Transplant team’s decision to purchase BMT Software is a priority based on the limitations of the existing Access database, current and projected program growth, as well as a time-sensitive funding opportunity made available by a grateful donor. Method: A team was created which consisted of the Director of the BMT Program, Director of the Allogeneic Stem Cell Transplant Program, BMT Program Manager, BMT Lead Data Manager, and Clinical Data Manager. We scheduled demonstrations from three leading BMT Software vendors. In addition, we interviewed data managers experienced with 2 out of the 3 vendors. The initial review of bids identified a lead vendor, due to budget and lab functionality. The second vendor closed for business soon after the demonstration and the remaining vendor’s product did not have the available features. Results: The vendor we elected to move forward with required detailed information regarding services to be included in the budget. CIBMTR reporting requirements draw data from a variety of applications including both inpatient and outpatient. UMMC IT assessment is essential to define the true resource requirements and a time-line for proper implementation. The team met to evaluate the following: to analyze updated vendor information, define UMMC IT resource requirements and implement a time-line. Subsequent meetings included discussing the project implementation plan including a budget and time-line, as well as information and presentation to the donor for funding request. Finally, the proposal, budget, time-line and funding were presented to the UMMC IT Steering Committee. At this point, UMMC IT identified possible potential technical and support pitfalls discovered in their discussions. These will be addressed prior to finalizing the contract. Conclusions: We are in the process of purchasing a highquality BMT informatics software program to do the following: enhance quality and efficiency of clinical data capture and analysis for CIBMTR; heighten quality and efficiency of clinical data retrieval for quality management and improvement; and provide a high-quality data base for clinical research. After researching and collaborating on the best possible BMT informatics software program, UMMC’s BMT team and IT department elected to move forward with a promising vendor.
439 The Continuing Process on Optimizing Data Collection Camilla Roepstorff, Heidi Petersen, Ann-Mari Berthelsen. BMT Unit 4042, Rigshospitalet, Copenhagen, Denmark
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Introduction: Our center is preparing for JACIE accreditation and according to standard B9.1: “The Clinical Program must furnish evidence of its own periodic data audits to determine if data are accurate for evaluation of patient outcomes” e.g. outcome analyses on day +100, +180 and annually. Previously our center has presented a flowsheet and standard notes in the patients electronic files prepared to optimize the collection of data requested for the CIBMTR and EBMT registry and our centers local data base. Since the last presentation our center has been in the process of implementing these tools. Now the results from the first audit performed are available. Aim: To identify by auditing if the flowsheet and the standard notes are being used by the physicians when seeing the patients on day +100, +180 and annually. To identify by auditing whether these tools provide use full data. To identify whether the tools were success full implemented. Method: The tools are prepared by data managers, quality manager and the leading physician. The leading physician has introduced the tools to all the treating physicians. The flowsheet are placed in the patient file and are also available in the consulting room. In the first three weeks of the start-up the quality manager identified which patients were up for day +100, +180 and annually visits, and marked this on the file as a reminder to the physicians. Results: The audit included 18 consecutive patients who were up for day +100 visit and 11 consecutive patients for day +180 visit. The data we were looking for on day +100 were: Karnofsky score (KF), status of remission, GvHD and other complications. The data we were looking for on day +180 were: KF, status of remission, GvHD, other complications and pre status performance. Results day +100: 44% (8/18): All requested data available. 56% (10/18): KF missing. 44% (8/18): Status of remission missing. 11% (2/18): Status of GvHD missing. Results day +180: 27% (3/11): All requested data available. 36% (4/11): KF missing. 64% (7/11): Status of remission missing. 45% (5/11): Status of GvHD missing. 55% (6/11): Status of pre status performing missing. At this point of time we are unable to monitor the use of the tools at the annually visits due to our backlog. Conclusion: When these tools are used systematically they provide use full data for the registries. When performing this first audit with these tools it clearly shows that in the first three weeks of the start-up the tools are being used systematically. We believe that the main reason for this fine result is the helpful work by the quality manager identifying and marking patients who were up for day +100, +180 and annually visits. We are planning to re-introduce the tools in the beginning of October 2015 by identifying patients up for day +100, +180 and annually. We are performing the second audit late November 2015 and are planning to present the results at the Tandem Meeting 2016.
