Mt. Sinai ups care for cancer patients

2012 Davies Award winner believes oncology-specific EMR makes the difference

A majority of clinicians at The Mount Sinai Hospital using Epic's Beacon module, an electronic medical record (EMR) system designed specifically for cancer treatment, indicated the system improved patient care quality and safety. 

The hospital is part of Mount Sinai Medical Center, which also encompasses Mount Sinai School of Medicine.

HIMSS recently named Mount Sinai Medical Center the 2012 Davies Enterprise HIMSS Award of Excellence, citing several ways Mount Sinai had put its EMR to work on boosting patient care and reducing costs.

On the oncology front, Mount Sinai administered a survey developed by Epic in November 2012, eight months after it rolled out its oncology-specific Epic Beacon module. 

Lead researcher Kerin Adelson, MD, assistant professor of medicine at Mount Sinai School of Medicine, presented the results in December at the ASCO Quality Care Symposium in San Diego.

The Beacon module enables clinicians to chart evidence-based treatment plans and provides the capacity to store a database of approved treatment protocols, including supportive care for side effect management, says Adelson.

To take advantage of the database feature, he says, Mount Sinai created a council of experts, including oncology physicians, nurses and pharmacists, who spent more than a year and hundreds of hours clinically validating more than 400 treatment protocols. The council then grouped the protocols by cancer type and noted which supportive care treatments, such as anti-nausea medication, paired well with each protocol.

The Mount Sinai team found that nearly 80 percent of people using Beacon believed the system increased their day-to-day efficiency and improved the quality of patient care.

"Treatment plans and chemotherapy cycles for cancer patients are complicated, requiring multiple medications given at various intervals," says Randall Holcombe, MD, professor of medicine, Division of Hematology and Medical Oncology and director of Clinical Cancer Affairs for The Mount Sinai Medical Center. "Each patient's complex schedule needs to be planned out over a course of six to 12 months. The Beacon system makes that long-term plan available to any member of the patient's medical team and automatically adjusts a patient's schedule when the treatment plan is modified."

Storing a patient's medical information in one secure electronic location accessible to any of the patients' clinicians results in a number of benefits, Holcombe says. Most importantly, Mount Sinai clinical leadership is able to enter evidence-based treatment protocols for their care practitioners to follow, which include supportive care for side effect management, he adds. EMRs also decrease the possibility of notes or test results being misplaced, reduce orders for duplicate tests, and vet prescribed drugs and doses in each patient to prevent life-threatening medication errors, he says.

"The major takeaway from our Beacon implementation is the opportunity to continuously improve and update treatment plans based on published research and guidelines for all practitioners to follow," says Adelson. "Ultimately, it allows us to provide higher quality, more comprehensive care to individuals by identifying the most appropriate treatment course while minimizing side effects."