Gustav optimizes oncology trajectories with new prescription functionalities

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As part of the opening of Quebec City's new integrated cancer center (CIC), HOSPITALIS developed, in collaboration with the CHU de Québec, new prescription functionalities integrated into the Gustav software to optimize care trajectories for chemotherapy patients with the aim of creating a paperless environment.

This achievement took shape through an iterative agile co-development approach with the HOSPITALIS team and a multidisciplinary team of professionals from the CHU de Québec in order to properly address all the needs of the various stakeholders involved. These iterations, born of systematic meetings, resulted in a product refined to the needs of the environment.  

Facilitating the chemotherapy treatment trajectory

The project was ambitious, as it had to implement a multidisciplinary and structuring electronic chemotherapy prescription software for oncology treatments. 

The major requirements were to:

  • Combine two oncology departments at CHU de Québec that operate differently
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  • Harmonize, optimize and further secure the processes surrounding chemotherapy prescribing
  • Establish better prescribing and communication paths for stakeholders
  • Provide a paperless solution to avoid certain errors, reduce risks and contribute to a greener work environment
  • Enable traceability capability to promote sharing between teams while reducing the likelihood of errors

Collaboration was central to this project, as all stakeholders needed to be able to collaborate with ease despite the difference in function. The aim was therefore to integrate secure, easy-to-use software to harmonize care trajectories for chemotherapy patients.

Collaboration at the heart of development

The means to be put in place in order to achieve a result that was efficient and easy to master for all users were exhaustive. Cross-functional collaboration between all levels of management was an obvious requirement. 

In order to promote the use of the new system, the company had to be able to take advantage of the latest technologies.

With a view to fostering optimal exchange between the various users, a tactical committee  made up of multidisciplinary stakeholders was created. This was done in close collaboration with the HOSPITALIS team throughout the process. 

The analysis of the trajectory was carried out by the HOSPITALIS team.

The analysis of current care trajectories and the ideal chain was constantly being updated. It was imperative to implement improvements in gradual phases, while maintaining close communication in order to adapt the management tool to its user. 

In addition, teams were trained and supported throughout the process. Gustav  software enabled different types of professionals to access their respective editing rights. It also lightened the workload thanks to prescription protocolization and automatic dose calculation functionalities based on weight and height. 

Innovations for chemotherapy treatments

The results of this collaborative method are striking. The importance of information integrity was noted with 87.6% of prescriptions having at least one addition or modification to it by another stakeholder. 

This is also more than 515 prescriptions configured in the Gustav software to support patients undergoing chemotherapy treatment. That's 308 prescriptions from the outpatient clinic for intravenous chemotherapy, 60 prescriptions for oral anti-cancer drugs and 147 prescriptions for drugs under research protocol. 

The project has also enabled us to provide a wide range of services to our patients.

The project has also enabled the gradual implementation of pre-printed prescriptions for parenteral chemotherapy. The average rose to 177 prescriptions per week following the first 15 weeks of implementation. The Gustav software saves 8 steps in the prescribing process compared with the paper pathway.

This is a major improvement that has met the need for safety and efficiency in the use of chemotherapy prescriptions. Traceability and ease of use are also key factors in demonstrating the breadth of support offered by Gustav software. It's important to note that no other software offered such flexibility and efficiency.

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Even more so, as the software engineering know-how of the HOSPITALIS team has enabled the development of generic prescription functionalities that can be fully configured by pilots according to clinical needs, and thus fully serve the needs of other specialties.

Beyond expectations

The project has proved particularly effective. There was a significant time saving in the transmission of documents between stakeholders. Restricted access to sections according to stakeholder types and traceability of changes on each file also greatly improved security. 

The harmonization of paths so that different teams can collaborate effectively according to document type is major. It enabled us to eliminate a total of 19,272 steps in 15 weeks, which represents a significant time saving. 

The entire team was able to adopt the project in just nine weeks. Despite a reluctant attitude in the early stages, they demonstrated significant satisfaction following the project's implementation. This is a successful paperless innovation that demonstrates direct impacts on the safety and quality of patient care, as well as on the efficiency of multidisciplinary clinical teams.

A highlighted contribution

The innovation that HOSPITALIS has brought to oncology trajectory management has not gone unnoticed. The project will be exhibited at the Ensemble, en réseau, pour vaincre le cancer édition 2021 virtual congress on November 18 and 25.

With manpower shortages a major problem in healthcare institutions, it's becoming imperative to optimize management tools. The evolution of Gustav will open up new possibilities while having a direct impact on patient well-being.

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