Managing a safe transition to new treatment guidelines

Cloud-based technology has enabled one healthcare provider’s swift transition to a new cancer treatment guideline.

The private Sydney Adventist Hospital (the San) in Sydney’s north is an early adopter of the NSW Cancer Institute’s guideline for anticancer drug dosing in kidney dysfunction (ADDIKD). 

Initially published in 2022, the evidence-based guideline on eviQ standardises the measurement of kidney 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 to the San, being the largest private cancer centre in New South Wales: besides cancer treatment, it offers a range of other day treatments, such as blood transfusions, immunoglobulin infusions, non-cancer immunomodulating therapies, and iron infusions, among others. It has grown to receive over 17,000 patient visits each year.

It reckoned that the transition to a new or updated cancer treatment protocol is usually tedious; the San had previously relied on manual screening to detect patients with kidney dysfunction where the Cockcroft-Gault method was not appropriate, and clinicians and pharmacists had to calculate and compare dose adjustments manually for their patients.

PROPOSAL

Since the hospital books cancer patients for treatment several months in advance, the hospital’s protocol governance working party decided to take a two-pronged approach in adopting the ADDIKD guideline while leveraging a cloud-based medical oncology and administration platform by healthcare SaaS provider EpiSoft.

MEETING THE CHALLENGE

While pharmacists and clinicians reevaluated dosing decisions for upcoming patients, taking into account the calculated doses recommended by EpiSoft, treatment protocols were also being upgraded for new patients through a “rigorous” approval process. 

But since EpiSoft has prebuilt the eviQ protocols (with the ADDIKD guideline incorporated) to the San and all its cancer sites, its clinical governance committee “just needs to review, customise if required, and approve the protocols with minimal manual data entry,” according to the health IT provider.

RESULTS 

Through EpiSoft’s oncology management system, much of the workload in the San’s transition to the ADDIKD guideline was greatly reduced – it imports eGFR pathology results used to calculate carboplatin doses in near real time and it enables clinicians to quickly compare the Cockcroft-Gault and eGFR (estimated Glomerular Filtration Rate) calculated doses. The system also copies dosing decisions forward to all future care cycles, subject to periodic review.

“The integration of EpiSoft with eviQ and the ADDIKD guideline has made the transition possible in a short time frame in our busy cancer centre,” attested Lily Chong, project pharmacist and EpiSoft system administrator for the San.

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