Managing a safe transition to new treatment guidelines
Cloud-based technology has enabled the rapid transition from one healthcare provider to a new cancer treatment guideline.
The privately owned Sydney Adventist Hospital (the San) in northern Sydney is an early adopter of the NSW Cancer Institute’s Guideline for Anticancer Drug Dosing in Renal Dysfunction (ADDIKD).
The evidence-based guideline on eviQ, first published in 2022, standardizes the measurement of renal dysfunction to provide more appropriate dose recommendations compared to existing calculation methods.
THE CHALLENGE
The transition to this guideline posed a significant change management challenge for the San as it is the largest private cancer center in New South Wales: in addition to cancer treatment, it provides a range of other day treatments such as blood transfusions, immunoglobulin infusions, non-cancer treatments, including immunomodulatory therapies and iron infusions. It has grown to more than 17,000 patient visits per year.
It found that the transition to a new or updated cancer treatment protocol is generally unpleasant; de San previously relied on manual screening to identify patients with renal impairment where the Cockcroft-Gault method was inappropriate, and physicians and pharmacists had to manually calculate and compare dose adjustments for their patients.
PROPOSAL
Because the hospital books cancer patients for treatment several months in advance, the hospital’s protocol management working group decided to take a two-pronged approach to adopting the ADDIKD guideline while leveraging a cloud-based medical oncology and administration platform from SaaS provider EpiSoft in health care.
MEETING THE CHALLENGE
As pharmacists and physicians reevaluated dosing decisions for future patients, taking into account the calculated doses recommended by EpiSoft, treatment protocols for new patients were also upgraded through a “rigorous” approval process.
But since EpiSoft has pre-built the eviQ protocols (which incorporate the ADDIKD guideline) for the San and all its cancer sites, the clinical governance committee “just needs to review, modify as necessary, and approve the protocols with minimal manual data entry,” said the healthcare IT provider.
RESULTS
EpiSoft’s oncology management system has significantly reduced the workload of transitioning from the San to the ADDIKD guideline – it imports the eGFR pathology results used to calculate carboplatin doses in near real time and allows clinicians to quickly review the Cockcroft -Gault- and eGFR (estimated glomerular filtration rate) calculated doses. The system also copies dosing decisions to all future care cycles, subject to periodic review.
“EpiSoft’s integration with eviQ and the ADDIKD guideline has enabled the transition in our busy cancer center in a short time,” said Lily Chong, project pharmacist and EpiSoft system administrator for the San.