Overview of Chemo Order Entry

Topics:

Writing Chemo Orders

Chemo Treatment Plans

Restrictions to Editing Chemo Orders

Changing Chemo Orders in an Oncology Protocol

Editing Chemo Orders Before Activation

Editing Active Chemo Orders

Exception Orders

Reusing Previous Orders

Defining Approval and Authorization

Approving Chemo

Desensitization

Activating Chemo Orders

Activation Dates and Expiration of Inpatient Chemo Orders

Ordering, Activation, and Expiration of Chemo Pre-Admission Orders

Activation Dates and Expiration of Ambulatory Chemo Orders

Expiration of Active Chemo Orders

Handling Orders Across Treatment Locations

Sending Chemo Sessions Between MGH Inpatient & Ambulatory

Standing Orders for Ambulatory Chemo

A protocol, as defined in Order Entry, is an investigational course of treatment that must be administered as designed to maintain scientific integrity. However, with the well-being of the patient as the overriding consideration, there are options for discontinuing the chemo medications administered in a protocol, or discontinuing treatment entirely.

  • Dose modifications: These modifications are defined within the protocol structure, in response to specific results. For example, if the patient's platelets drop below 50,000, the protocol might define a decrease in dose of 10% for a specific agent. The modifications, if defined, are offered automatically when you click either the Standard Dose or the Total Dose field for the order. See Changing the Dose of an Active Chemo Order.

  • No zero dose: For any active chemo order in a protocol, you can discontinue the order if needed. You cannot edit the dose down to zero (0). You must provide a reason for discontinuing a chemo order, which can be reinstated when appropriate. See Discontinuing Chemo Orders.

  • Ending treatment: If you want to completely discontinue treatment based on a protocol, and treat the patient using a standard regimen:

  1. Discontinue any and all active chemo medication orders. See Discontinuing Chemo Orders.

  2. Record the end of treatment date. See Ending Treatment From a Protocol.

  3. Write orders from the regimen. See Ordering Chemotherapy.