Securing drug prescription and administration: the case of chemotherapy

Summary Decision support, order entry, drug and care administration with their respective documentations cannot be seen as independent actions, especially in terms of medical approach and patient safety. Chemotherapy offers a good illustration of the varied implications of technology information in these multifaceted and intricate processes. Chemotherapy administration can be a highly complex process. It can take place over a variable period of time ranging from hours to several months. Usually it involves numerous actors around the patient, such as physicians, pharmacists and nurses. Chemotherapies can be produced specifically for a given patient and can have dramatic effects if errors occur. Chemotherapy depends on various information, including patient-specific data such as temperature, weight or laboratory findings; drug-specific knowledge such as side effects or administration directives amongst others. At the University Hospitals of Geneva (HUG), critical process reengineering accompanied by new applications covering the whole chain of processes involved in chemotherapy, from prescription to administration including preparation, have been developed. This paper presents the overall approach leading to computerisation of these processes.