A young man presents in the Emergency Department with pain in his foot, probably secondary to gout. In triage, he mentions his involvement in an ongoing clinical trial of an oncology treatment regimen. An order is generated for pain meds. The ED pharmacist, before verifying the order, reviews the triage notes, and gathers additional information from the patient and his attending physician. The patient indicates that he contacted his study coordinator prior to the ED visit, and had gotten instructions to take a narcotic pain medication at home and visit the ED if the pain worsened. Satisfied that the ordered medication won’t endanger the patient or impact his participation in the clinical trial, the pharmacist releases the order.
This is a true story. While everything worked out for the patient in this case, there remains an element of, shall we say… serendipity. Luckily, the patient was able to let the ED team know that he was on a study, and luckily the ED team got the information it needed in a timely way. But what if it hadn’t turned out that way?
To lessen the element of chance in stories like these and thereby improve patient safety, the CTSI and the eRecord team are unveiling new features in eRecord on October 29. The new capabilities will allow patients in eRecord to be “flagged” as research subjects, and linked to a specific research study. Providers will be able to get key treatment-related information through eRecord and a 24-hour contact number for more information.
In order to use the new eRecord features, users will have to take an online training course. If you haven’t received an email invitation for the training, contact ResearchHelp@urmc.rochester.edu. The Research Subjects Review Board (RSRB) must approve the flagging process for each individual study before any patients may be linked. Guidance for investigators, including how to request approval, is available on the RSRB website (see the “seminar materials” page – specifically the 9/17/2013 RSRB Update). At any time, you can contact ResearchHelp@urmc.rochester.edu if you have questions or need help.
With the new eRecord features, we’ll be able to re-write these stories, so they’ll sound more like this:
A young man presents in the Emergency Department with pain in his left foot, probably secondary to gout. In triage, the ED team discovers that he is involved in an ongoing clinical trial of an oncology treatment regimen. A review of study information in eRecord describes the drugs being administered and lists contraindicated agents. An order is generated for pain meds with this information in mind. The ED pharmacist reviews all the information. Satisfied that the ordered medication won’t endanger the patient or impact his participation in the clinical trial, the pharmacist promptly releases the order.
Editor’s Note: Many thanks to Manish Shah MD and Kristan Vollman PharmD from the Emergency Medicine Department for the patient story included above.