Kids' cancer ward uses Office 2003 app

Starship Children’s Hospital in Auckland will soon begin a pilot of InfoPath, a new application in the recently released Microsoft Office 2003 suite, to produce electronic cancer drug prescriptions.

InfoPath creates XML-based electronic forms, which can change dynamically as the data is altered.

Starship paediatric oncologist David Mauger, speaking at a launch of Office 2003 in Auckland last week, said the hospital’s current paper-based prescription system is vulnerable to potentially fatal mistakes, particularly given the powerful drugs that are used to treat cancer patients.

“Oncologists at the Starship fill out a drug order form, with patient details etc. Some of that information, after being forwarded to the pharmacy, results in a second form being made by the pharmacy,” says Mauger, “and the checking of the calculation is done by the pharmacy.”

Instances overseas of patients dying because of prescription errors was the reason the hospital looked for a replacement, Mauger says.

The Starship, part of the Auckland District Health Board, looked for an electronic system both in New Zealand and elsewhere. After finding nothing suitable, “the only option was to develop our own”.

After consulting with Microsoft and the Simpl Group, InfoPath was chosen as the platform for the prescription system.

Now, electronic ones will be developed using InfoPath instead of paper forms. When the electronic form is completed, one copy will go to the pharmacy, one to the ward and one to the database. The trial, which will use wireless-enabled PCs, will keep the prescription information in a separate database in the short term, though in future it will be integrated into the main hospital systems.

Functions were added during the work with Simpl. These included putting in place a methodology that allows all the calculations involved in switching from the original document to the prescribing one to be done without specific programming, Mauger said in a subsequent interview. “It’s a generic tool.”

The modified InfoPath was chosen over other e-prescribing systems largely because of the ease with which it could be applied to the demands of cancer treatment, Mauger says. “Part of it is being able to prescribe a block of drugs at one time. Cancer treatment relies on multiple drugs being given at the same time with the combination tightly controlled, and InfoPath has a lot of flexibility. It’s okay whether you’re prescribing one drug or 10.”

InfoPath features such as repeating sections allow the degree of replication between paper and virtual forms required by the paediatric oncology department, he says.

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