Institut Català d'Oncologia
17- 19 october 2016, Barcelona
Interface Management of Pharmacotherapy
Institut Català d'Oncologia
ICOpraxis implementation tool for prescription of drugs:
ESPOQ
Montserrat Rey SalidoESPOQ Coordinator
18/10/2016
Institut Català d'Oncologia
Chemotherapy proceedingsChemotherapy proceedings
ESPOQ
Eina de Suport Prescripció Oncològica de Quimioteràpia
Tool that supports all phases of the chemotherapy managment
( prescription, pharmacy check, preparation, supply and
administration)
Institut Català d'Oncologia
Objectives
• ESPOQ (Chemotherapy Process Support Tool ) is the integrated application that supports the activity of the chemotherapy process at the ICO.
• ESPOQ integrates all processes: prescription, pharmacy check, preparation, chemo dispensing and administration of chemotherapy care plan.
• Internally developed based on the experience and knowledge of the organization, the program has a length of more than 10 years.
Institut Català d'Oncologia
Objectives• ESPOQ (Eina de Suport al Procés Oncològic i de Quimioteràpia)
The objective of the comprehensive managment is:
� Knowledge management related to cancer care� Security management process Chemotherapy
PRESCRIPCIÓN MÉDICA
(CONSULTA EXTERNA)
1
PRESCRIPTION
1
DAY HOSPITAL SCHEDULE
2 3
PRESCRIPTION PHARMACIST
CHECK
4
CHEMOTHERAPY MANUFACTURING
5
SUPPLY
6
CHEMOTHERAPY ADMINISTRATION AND
PATIENT CARE
FOLLOW UP: RESULTS AND TOXICITY
Security management Knowledge management
Institut Català d'Oncologia
• ESPOQ (Eina de Suport al Procés Oncològic i de Quimioteràpia)
Objectives
Institut Català d'Oncologia
ObjectivesThe new comprehensive approach required the addition
of a number of important functional improvements such as:
1. Knowledge Management:a) Management decision algorithms for implementation
ICOPraxisb) Pathology results and blood analysis data integration.
c) Clinical record data exchange (pharmacists, doctors and nurses records)
d) Plans for standardized care treatment protocole) Result orientation based on dynamic forms: including
RPT CatSalut
Risk-sharing recordsf) Electronic prescription: interface online
g) Management Clinical Trials
Institut Català d'Oncologia
Objectives2. Security management
a) Improved traceability of the process to minimize risks in the process of preparation, dispensing and administration: use Data Matrix technology
b) Improvements in day hospital management.
c) Improvements in the administration of treatment (order in administration, patient identification and treatment)
d) Improvements in the register of adverse effects and allergies, chemical phlebitis and extravasation in the administration.
e) Improvements in managing outpatient dispensing: documentation and adherence to patient drug information
3. Management activity indicators, safety and quality QCa) Clinical Management: Information costs /
pathology
Institut Català d'Oncologia
Project’s Scope
• The project represents a significant improvement in the process chemotherapy and affect the activity of all professionals: doctors, pharmacists, nurses and technicians.
• The application features require a maximum level of quality in its development and implementation, because of the impact of the application in process safety.
Institut Català d'Oncologia
ASSISTED ELECTRONIC PRESCRIPTIONASSISTED ELECTRONIC PRESCRIPTION
�� Protocol /Diagnoses: Agreed protocols Protocol /Diagnoses: Agreed protocols
-- ICOPraxisICOPraxis
-- Clinical trialsClinical trials
��Protocol informationProtocol information
�� Anthropometrics individualized dose adjustmentsAnthropometrics individualized dose adjustments
�� Associated treatments to ChemoAssociated treatments to Chemo
�� Warnings: Dose and anthropometrics outlyersWarnings: Dose and anthropometrics outlyers
�� Previous toxicities warningsPrevious toxicities warnings
�� Medical record integrationMedical record integration
PRESCRIPTIONPRESCRIPTION
Institut Català d'Oncologia
PRESCRIPTION:PRESCRIPTION: Protocol/Diagnose
Institut Català d'Oncologia
PRESCRIPTION: PRESCRIPTION: Protocol’s information
Institut Català d'Oncologia
PRESCRIPTION:PRESCRIPTION: Other drugs associated to ChemoOther drugs associated to Chemo
Institut Català d'Oncologia
PRESCRIPTION:PRESCRIPTION: Anthropometrics warning
Institut Català d'Oncologia
PRESCRIPTION:PRESCRIPTION: Maximum dose alert
Institut Català d'Oncologia
PRESCRIPTIONPRESCRIPTION : Oral Chemo
Institut Català d'Oncologia
SUPPLYSUPPLY: dispensing check
Institut Català d'Oncologia
Pharmacist checkPharmacist check
��Verify patient dataVerify patient data
�� Protocol / Diagnosis Protocol / Diagnosis --> ICOPraxis> ICOPraxis
�� Chemo recordChemo record
�� Check every cycleCheck every cycle
�� Medication related to chemotherapy. Medication related to chemotherapy.
�� Prior toxicity warningPrior toxicity warning
�� Protocol modifications warningProtocol modifications warning
�� Checking changes: dose, route, time management ...Checking changes: dose, route, time management ...
�� Medical record integration. Medical record integration.
Institut Català d'Oncologia
CHECK:CHECK: MODIFICATION WARNINGMODIFICATION WARNING
Institut Català d'Oncologia
Check:Check: Interventions registryInterventions registry
Institut Català d'Oncologia
Check:Check: TTraceabilityraceability
Institut Català d'Oncologia
Manufacturing:Manufacturing:SafetySafety
Institut Català d'Oncologia
Manufacturing:Manufacturing: Gravimetric QAGravimetric QA
Institut Català d'Oncologia
MHDA Registry MHDA Registry
��Mensual shippingMensual shipping
�� Tracking variables unified with prescription Tracking variables unified with prescription
forms :forms :
�� Base FormBase Form
�� Follow up FormFollow up Form
�� Closure formClosure form
�� Compulsory to fill in the forms to prescribeCompulsory to fill in the forms to prescribe
Institut Català d'Oncologia
MHDA Registry MHDA Registry