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

Sending chemo sessions between MGH inpatient and MGH ambulatory—As of December 13, 2011, providers at all MGH locations can send chemo sessions that are still awaiting activation from the inpatient order entry to ambulatory order entry, and vice versa. There are a number of restrictions; when these apply, see Handling Orders Across Treatment Locations.

• Orders can only be sent between MGH inpatient and ambulatory units—other DFPCC (Dana Farber Partners Cancer Care) facilities are not included.

• The only orders you can send are those that are awaiting activation. This includes orders with the Pre-admit, NICO, or ambulatory Pending status.

• Before sending, orders must be signed as approved or authorized when required.

• Chemo involving desensitization cannot be sent, because pharmacy processing differs considerably between the inpatient and ambulatory settings.

• Only orders written in chemotherapy order sessions—"from the Chemo button"—can be sent. This includes the chemo-related orders in session #1, as well as the chemotherapy orders in sessions #2 and #3. Non-chemo orders, whether pre-admission and ambulatory, cannot be sent to another site.

What is sent?—Chemo sessions #1 (chemo-related orders) and #2 (chemotherapy) are sent as a pair when either is selected to be sent. Chemo session #3 (chemo that can be activated by a non-RN) can be sent alone, or with sessions #1 and #2. If the treatment includes multiple sets of sessions, spanning two (2) or more weeks, the provider has the option to send the selected sessions and any sessions that follow.

Who can send?—Providers with authorization to write chemotherapy can send orders between sites. Orders sent by Oncology Fellows, Nurse Practitioners, and Physician Assistants do not require additional approval. RNs, pharmacists, and administrative staff cannot send chemo orders to other care units.

Procedure—Select the chemo sessions to send from the list of chemo sessions awaiting activation. You are prompted to choose whether to send only the selected order session, or to send remaining sessions as well. The orders must be reviewed and signed before the sending process is complete. See Sending Chemo Sessions.

Demonstration—Sending Chemo Sessions from Inpatient to Ambulatory.