Leveraging Informatics to Manage Lifelong Monitoring in Childhood Cancer Survivors

Background: Electronic health records (EHR) have long held promise for sharing information efficiently, but this remains challenging. This quality improvement initiative sought to improve the accurate documentation of anthracycline and radiation therapy exposures in pediatric oncology patients who were treated at different institutions through a quality improvement methodology and EHR tools. Methods: A custom-built EHR smartform was previously created. Modifications were made to the smartform, and quality improvement methods were utilized to improve receipt of radiation summaries from other institutions and documentation of chemotherapeutic doses. Results: Three months after interventions, including clinician education and smartform updates, accurate anthracycline documentation improved from ≤60% to 100%. At 12 months post-intervention, accurate anthracycline documentation remained > 90%. Documentation of radiation therapy improved similarly at 3 months post-intervention, with sustained improvement to 81% at 12 months post-intervention. Conclusions: Accurate documentation of radiation and chemotherapeutic exposures for pediatric oncology patients improved with education and changes to an EHR smartform. A central data location with quality assurance tools to ensure accuracy is one solution enabling accurate tracking of exposures and care plans for children with chronic illnesses.