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Transitioning to Electronic Charting for LDR Prostate Brachytherapy (LDR-PB)

P Kapoor1,2*, B Curran1,2, R Kapoor1,3, M Schutzer1,2, D Moghanaki1,2,4, (1) Virginia Commonwealth University, Richmond, VA, (2) Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, VA, (3) National Radiation Oncology Program, Richmond, VA, (4) Atlanta VA Health Care System, Decatur, GA


(Sunday, 7/12/2020)   [Eastern Time (GMT-4)]

Room: AAPM ePoster Library

Purpose: Radiotherapy clinics are increasingly transitioning towards a paperless environment to improve electronic access to patient records, improve documentation organization, decrease physical-chart storage space, and reduce the risk of missing charts whenever patient data are needed. However, such migration for managing documentation related to LDR-PB due is much more difficult due to extensive regulatory requirements that electronic health record systems are not currently designed to manage.

Methods: A process map was developed to identify the major and minor steps in the LDR-PB process at a Veterans Affairs (VA) medical center. Approval from obtained by the VA’s National Health Physics Program for use of electronic signatures with LDR-PB documentation. A well-organized documentation system consisting of checklists, timely user-oriented reminders and documentation scripts were developed to create a seamless electronic workflow. Various functionalities of the electronic medical record (ARIATM) such as Care Paths, Patient Encounters, Questionnaires, and Dynamic documents were used to streamline and standardize the workflow in our clinic. Interfaces were built for the VA’s Computerized Patient Record System and ARIA to seamlessly communicate the patient encounter and clinical documents. An implementation assessment was completed after the first 15 cases to identify the differences between the two workflows.

Results: Eleven electronic documents have been created for the whole process, out of which fields in five document templates get prepopulated with relevant data from patient's chart such as diagnosis codes, simulation, and special physics form fields, leading to improved workflow efficiency of the staff involved. The transcription error rate has reduced, and the clinical documentation time has been reduced by 23.3%.

Conclusion: Key attributes for successful implementation of electronic-charting were the creation of the process maps and how tasks were assigned to appropriate team member groups. The staff involved in the process embraced the changes in workflow with training, teamwork, and commitment.


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