Being able to enhance and streamline clinical and administrative workflows in oncology is critical for boosting care quality and access for the Department of Veterans Affairs (VA).

With dynamically changing workflows causing interruptions in team communications that can result in delays in patient care and even human error, the VA can now thankfully leverage DSS' Order Tracking Manager (OTM) for Oncology. This easy-to-use, web-based, VistA-Integrated solution powers real-time data for providing clear oversight and task management for staff and administrators.

In the following Q&A, Jamie Leachman, RN BSN, senior product line manager at DSS, discusses how OTM Oncology provides better visibility into all aspects of Veteran care related to oncology, as well as how the solution reduces administrative burdens and enhances care access.

The following has been edited for length and clarity.

Q: Before we dive in, can you tell us about the pain points and challenges that the VA faces when it comes to achieving streamlined clinical and administrative workflows to oncology?

Jamie: DSS' OTM Oncology is an application designed to improve the workflow within the many Oncology/Infusion clinics that operate at the VA.

One of the biggest challenges is that dynamically changing workflows cause interruptions in team communications and can result in delays in patient care. Each clinic also has specific workflow needs, and communication deficiencies result in obstacles slowing down the processes and administration of patient care needs.

The challenge is that the primary methods of communication and workflow among the various team disciplines at oncology sites within the VA involve extensive use of Teams messages and phone calls. This process often begins with patients being scheduled for their treatments and therapies. The VA utilizes several oncology clinics, and once a patient's appointment is set, the workflow involves managing lab orders and medication orders.

In addition, lab orders must be completed within a specified number of days before therapy, and medication orders include drugs that need to be administered before, during, and sometimes after the therapy.

Whether a therapy session proceeds as scheduled often depends on these lab results. Therefore, after a patient checks-in, the nurse must locate the lab orders, review the lab results, and communicate with the provider to confirm that everything is in order. Once confirmed, the necessary medication orders are signed off, and the therapy can continue as planned.

After the lab and medication orders are confirmed, the next step involves processing these orders through the pharmacy. If any medication needs to be mixed and cannot be delivered directly through the Omnicell system, additional time is required. This often leads to phone calls between the pharmacy and the treatment team to ensure the provider is aware and ready to sign off on the orders, so the process can begin.

There's continuous communication between the clinic's treating team and the pharmacy to notify them when medications are ready or when they've been allocated through the Omnicell for delivery. These interactions highlight the key sources of delays within the current workflow.

Q: Please tell us about DSS' Order Tracking Manager (OTM) for Oncology and how it can help address these challenges.

Jamie:The OTM Oncology application addresses the clinic workflow needs by providing real-time patient and clinic data to provide clear oversight for the staff.

With customizable clinic worklists for each staff member, team members can quickly organize their views to prioritize workflow activities. Centralized, real-time views of clinic and patient data facilitate rapid communication among the entire team, helping to prevent delays in patient care.

The application provides schedulers with direct access, allowing them to complete scheduling within the application itself. If schedulers are still using VSE or VistA for scheduling, the application can capture and display that information as well.

The application provides real-time visibility into all actions taking place. For instance, if a lab result is pending, the team can be notified immediately once it's available. They can then quickly view the lab result within the application, ensuring continuous communication. Additionally, the application allows team members to visualize and track the patient's exact location within the clinic-whether it's a specific pod or chair.

This information is captured and documented within the application, facilitating rapid and accurate communication. Team members can also leave comments that can be reviewed throughout the course of therapy, further enhancing collaboration.

This flexibility makes the workflow smoother, as scheduling can be managed in either system. Additionally, nurses, providers, and pharmacy staff all have access to the application, ensuring seamless coordination across the team.

Q: Please share some more insights around the OTM Oncology Worklist.

Jamie: The Clinic Worklist (dashboard) offers a user-centric, customizable view tailored to the individual user's workflow. These views include worklist filters, enabling users to access detailed information with a single click.

Real-time data updates ensure that information is reviewed quickly, allowing patient care decisions to be evaluated efficiently and communicated to the entire team without delay.

The worklist provides an expanded range of information that offers a quick and easy review of the most pertinent data needed to complete a patient's treatment for the day. With just one click, users can evaluate the status of medication and lab orders directly from the worklist.

The application also features a patient's detail chart that defaults to the most important data, ensuring that critical information is readily accessible. Users can navigate to different domains within the patient's chart with a single click, whether they need more details on orders or a quick glance at progress notes.

Q: From a high-level perspective, how does OTM Oncology improve overall outcomes for clinic staff, pharmacists, administrators, and patients alike?

Jamie: The OTM Oncology application enhances clinic workflows by providing real-time patient and clinic data, ensuring clear oversight for the staff. With customizable clinic worklists, each team member can quickly organize their views to prioritize workflow activities.

Essentially, OTM Oncology helps resolve issues like wasted time logging in and out of email, streamlining pharmacy efforts regarding which patients' orders have been cleared. It also enhances immediate scheduling, waiting room management, and removes human error for things like missed patient names.

When it comes to pharmacy coordination, the application streamlines communication by focusing solely on the medication orders specific to the patient's therapy. Patients often see multiple providers across different clinics and may have numerous medication orders unrelated to their oncology treatments. The application filters these orders to highlight only those relevant to the patient's current therapy in the oncology clinic. For instance, it can narrow down a list of 25 medication orders to just five, allowing the team to concentrate on the medications needed for today's therapy treatment.

Additionally, metric reports enable care team members to evaluate patient care over a selected period, helping to identify potential gaps or roadblocks in the workflow.

Q: Finally, how does OTM Oncology enhance care access at the VA, as well as support its journey to becoming a High Reliability Organization (HRO)?

Jamie: OTM Oncology supports the VA's journey to becoming an HRO by enabling multidisciplinary teams to collaborate, placing patients at the center of care by focusing on efficiency and maximizing quality care.

The application emphasizes tracking clinic and patient workflows, providing high visibility of real-time patient data in a central location to improve team communication. It also offers quick access to detailed patient information, facilitating an enhanced patient experience.

The application keeps the focus on patient care by removing roadblocks that cause delays in timely treatment. By streamlining workflows and eliminating obstacles, the application allows the team to meet the needs of more patients each day or week, while also maximizing the quality of care. The added benefit of having secondary oversight on everything further enhances the overall care provided.

Q: Anything else to add?

Jamie: I would like to add that this application is not a replacement for our Infusion Therapy Manager (ITM) or our VCM Web solutions; rather, it serves as an adjunct. While ITM and VCM address broader clinical treatment perspectives, this application focuses specifically on addressing workflow issues within the clinic.

OTM Oncology is designed to complement existing systems by streamlining clinic-specific processes, ensuring both workflow efficiency and the continuation of high-quality clinical treatment.

We would like to thank Jamie for sharing her insights with us! To learn more about OTM Oncology, please click here.

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