Table 2.

Challenges of Oncology Workflow

Challenges	Concerns
Treatment selection should be based on established guidelines and/or best practices.	1. The oncologist's database for receiving information from pathology, labs, and other diagnostic studies may be incomplete. 2. There is no single authoritative source for verification of the drug regimen. 3. Patient assessment for eligibility for clinical trials may be incomplete.
Modification of treatment regimens should be based on accepted toxicity guidelines (National Cancer Institute's Common Terminology Criteria for Adverse Events).	1. Access to guidelines may be limited. 2. Documentation of toxicity may be incomplete, inconsistent, and may not use standard terminology.
Physician drug ordering is usually done on an individual basis.	1. This opens the risk of computational errors and drug interactions.
Patient handoff from physician to nurse or pharmacist increases the risk for errors.	1. Handwriting can be misinterpreted. 2. Admixture errors occur (wrong drug, wrong dose, or wrong route). 3. Maximum drug dose and lifetime cumulative dose may be exceeded. 4. There can be infusion incompatibilities.
Drug administration errors may occur.	1. Patients may be misidentified. 2. Documentation may be incomplete or inaccurate. 3. Charges may be missed.

Abbreviation: EHR, electronic health record.