Implementation of a Chemotherapy-Induced Nausea and Vomiting Dashboard.

e22519 Background: Chemotherapy induced nausea and vomiting (CINV) negatively impacts the quality of life of pediatric patients receiving antineoplastic agents. Our objective was to prevent CINV using a hospital wide electronic health record (EHR) based real-time surveillance system for automated CINV detection. Methods: A software program designed to provide hospital-wide data reporting was developed. The program utilizes a dashboard feature that extracts patient specific information on antineoplastic agents, antiemetic medications and frequency of emesis from the EHR. The extracted data are automated and available on a self-updating dashboard. Oncologists and pharmacists can utilize the dashboard to promote adherence to guidelines for medication administration. Results: The dashboard contains color-coded headings to designate low, medium or highly emetogenic potential for antineoplastic agents according to published supportive care guidelines. This color scheme is applied to antiemetic classes to facilitate ordering of the appropriate antiemetic regimen. With this design, adherence to supportive care guidelines can be quickly assessed as a component of patient care. Individual patients can be customized to allow for in depth review of selected cases, clinical outcomes and trends. A CINV surveillance team including a pharmacist and pediatric oncologist review the dashboard daily to direct prevention and treatment strategies. Conclusions: This novel EHR dashboard of a CINV surveillance system serves as a tool for pediatric oncology providers to facilitate optimal antiemetic care for patients. The system is auditable and HIPAA compliant. This tool allows for identification of at risk patients, both prospectively and in response to documented uncontrolled emesis. By identifying these patients efficiently, we are able to intervene with appropriate preventative and breakthrough antiemetic medications to improve the quality of care for pediatric oncology patients and improve compliance with published supportive care guidelines. Subsequent studies will utilize this dashboard to analyze changes in clinical practice and clinical outcomes in pediatric oncology patients in which optimal control of acute CINV is obtained.