Abstract
e18220 Background: In November 2014, Aurora Cancer Care (ACC) adopted a new software package called Via Oncology (Via). It is a software driven, algorithmic, decision support tool. Via's goal is to help providers make the best decision in the treatment plan for patient care. Eligible clinical trials are the preferred therapy choice. If not available, treatment choices are then ranked by efficacy, toxicity, then cost. Its use has been mandated for every patIent visit in the department of Medical Oncology. ACC has 19 sites of service. While our current electronic medical record (EMR) and Via do communicate, it is limited to demographics and sending a link of the selected pathway from Via to the EMR. However, this link does not need to be selected in the EMR and another treatment could be selected. Our group does not penalize for off-pathway decisions, but it is possible that providers are selecting one protocol in Via to count as "on-pathway", and entering another treatment plan in the EMR. The goal of this study was to determine the concordance of stated pathway on Via and the actual ordered therapy in the EMR. Methods: One month of pathway decisions for a large, hospital based, multisite oncology group were obtained. Those decisions in Via that were recorded as new "on-pathway" treatment decisions were manually audited in the EMR to determine if there was concordance. If discordant decisions were corrected on a subsequent visit, it was felt that there was likely a mitigating circumstance and these decisions were not included in the final analysis. Results: Over one month, our 39 oncologist made 1534 new decisions for patients. Of these, 368 were "on-pathway" in Via. There was concordance of 319 (87%) to our EMR. The discordant charts were mostly due to differing drugs (19), dosing schedule (8), drug omitted (7), never given (7), additional drug (2). Conclusions: Despite the mandated use to two mostly independent software systems, agreement was high among patient records. Further integration of these systems will likely result in even greater concordance.
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