Remote Ordering of Systemic Therapy

Due to the global pandemic of COVID-19, there will be circumstances where prescribers may need to self-isolate and are not able to be on site at the regional cancer centres to order systemic treatments. This BC Cancer Remote Ordering of Systemic Therapy Policy outlines the requirements for safe remote ordering of systemic therapy treatment as an interim process pending implementation of a fully integrated Electronic Health Record and Computerized Provider Order Entry.

This is a process for exceptional circumstances and not a parallel system to order systemic therapy for physicians working in a BC Cancer clinic or affiliated site.

Read the associated policy carefully before ordering ST remotely.

An SRFax procedure guide has been created to support physicians using this process.

The fillable PDFs are designed to be accessed, filled out and sent at the time they are needed.

They are available at H:\EVERYONE\SYSTEMIC\Chemo\Orders\Fillable Provincial PPOs

Why can't fillable PDFs be used to order Systemic Therapy?

PPOs are updated very frequently as protocols change. Fillable PDFs take significant support to keep accurate and current. It is not feasible to keep fillable PDF PPOs accurate at the rate they are update. Therefore, the remote ordering of systemic therapy is limited to printable PPOs.

The official order form for Systemic therapy is the PPO printable from the BC Cancer website. These meet all the accreditation and professional practice standards and established workflows in your centre have been set up over many years to support their use with a hybrid paper/EHR. We will be reviewing this, however, and will update if this position changes.

The provincial repository of fillable PDFs is maintained centrally and the content is updated regularly and aligned with the paper PPOs. This ensures a single "source of truth" and enhances quality and safety.

As COVID-19 cases increase in the community, don't we want to reduce the number of people in our clinics? Why is remote ordering only for exceptional circumstances?

Our existing hybrid paper/electronic health record and associated systems, means that many of the documents ideally needed for ordering systemic therapy are not routinely available electronically. A fully integrated EHR/Computer Provider Order entry system is the gold standard for remote ordering. Modifying a paper-based chemo ordering system to facilitate remote ordering introduces safety risks and inefficiencies.

On initial launch we need to get some experience and balance the risks to patients from this system.

The situation with COVID-19 is being monitored carefully and if circumstances change, we will consider adapting the policy to meet evolving needs.

Where do I access the PPOs from home?

PPOs can be found on the BC Cancer Chemotherapy Protocol webpage

Can I use the remote ordering system to email medication orders to CON clinics or community pharmacies?

No. BC College of Pharmacists regulations, do not allow pharmacists to accept medication orders emailed between Health Authorities. Intra-health authority emailed medication orders are allowed, only with the appropriate policy and systems in place to handle these orders safely.

Existing systems should be used for these orders at this time e.g CON referral to an onsite physician to order systemic therapy, fax to a CON pharmacy from a BC Cancer centre, phone in a prescription for supportive care medication etc. We are also working with health authority partners so, this could also change in the future.

Use the "Supplemental doctor's order for PPPO" located in H drive.

H:\EVERYONE\SYSTEMIC\Chemo\Orders\Fillable Provincial PPOs.

Fill in associated PPPO protocol code and cycle number to ensure the orders are linked to the appropriate PPPO once printed.

How do I order labs and tests?

Use the order forms created in your centre.

How do I use SRFax?

How to information can be found on the PHSA SRFax webpage

For more information, read the Systemic Therapy Staff Bulletin.

_{BC Cancer health professionals with questions about the content on this page may email the BC Cancer communications department.}