Table 3.

Oncology EHR Core Functional Elements

Element/Functionality
Treatment plan core elements	Flow sheet: inclusive of all chemotherapy,
Demographics, including referring provider and PCP	non-chemotherapy medications, transfusions, tumor measurements, lab values
Diagnosis: ICD-9 or 10; possibly more clinically relevant system
	Flow sheet: physical findings, including tumor measurements, imaging, relevant procedures, nursing assessment*
Stage
AJCC for relevant diagnoses: tumor registry staging system for other diagnoses
	Oncology-specific review of systems
Disease status at each course of therapy	Patient provided with copy of treatment plan and summary
Site/histology/pathology findings: menu-driven by disease
Intent/goals of therapy: adjuvant/curative v palliative	Documentation of investigational drugs
Performance status	Capture date of death*
List of comorbid conditions expected to complicate chemotherapy, eg, hepatic insufficiency	Oncology-specific EHR functions
	EHR-generated treatment plan
Cancer surgical history	EHR-generated treatment summary
Chemotherapy/biotherapy regimen planned	Ability to update treatment summary
Body surface area and starting doses	EHR application to generate specific reports, eg, specific types of flow sheets
Duration of treatment and number of planned cycles
Major toxicities associated with planned treatment	Mechanism to capture verbal orders*
Radiation therapy planned or previously delivered	Drug interaction alerts
Pain assessment and supportive care needs: advanced cancer	Basic safety limits for dosing
	Body surface area safety monitoring
Treatment on clinical trial	Lifetime cumulative chemotherapy dose
Sites of disease monitored: advanced cancer eligibility*	Clinical decision support, eg, guidelines or trial
Treatment summary core elements
Patient demographics	Treatment preauthorization support*
Chemotherapy/biotherapy delivered: IV and oral	Drug inventory control*
Number of cycles planned and administered	Internal and external communications*
Duration: date of first and last dose	Import key external reports, eg, pathology, operative note, radiation
Extent of dose reduction
Reason treatment stopped	Radiofrequency identification technology for patient/drugs given, eg, barcodes*
Major toxicities experienced
Hospitalization required for toxicity	Open database with query capabilities*
Disease status at completion of treatment	Interoperability: health information exchange with labs, imaging centers, etc.*
Performance status at completion of treatment
Coordination of follow-up care	Compliance safeguards
Provider contacts	Privacy and security safeguards in place
Other oncology-specific documentation	Disaster recovery plan in place

Abbreviations: EHR, electronic health record; PCP, primary care physician; ICD-9, International Classification of Diseases, 9th Edition; AJCC, American Joint Committee on Cancer.

* Denotes elements characterized by Roundtable participants as desirable, not critical.