A Chat About EMR Usage for CAR T-Cell Therapy

Electronic medical records (EMRs) are crucial tools for nurses and physicians treating patients with chimeric antigen receptor (CAR) T-cell therapy, allowing clinicians to track symptoms and analyze important patient vitals and statistics, according to Andrea Price, APN, associate director for clinical research at Washington University School of Medicine.

However, many EMR systems have not yet caught up to the challenges and data collecting needed for this type of therapy.

In a recent interview with Oncology Nursing News®, Price discusses the importance of the EMR when treating patients with CAR T-cell therapy, as well as what changes need to be implemented in the future.

What is the value of EMRs when giving CAR T-cell therapy?

The EMR is really what we use to drive our ordering process for CAR Ts, but more importantly, it's really allowed us to dive into … nursing considerations for how you can document [on] your patients receiving CAR-T therapy, how we can capture really useful assessments to help drive their care for side effects, for toxicities, especially if the patients start to decline. We really try to capture that in a meaningful way to help nurses and physicians make the right decision every step along the way.

What are the challenges?

The challenge is that CAR-T therapy doesn't seem really new to providers. But CAR-T therapy to medical records seems new. It wasn't really built for this type of therapy, which requires a lot of collaboration with your EMR team to make it fit the workflows and this special patient population.

The challenge is that it doesn't come out of the box with the tools that you need. You really have to design them from the ground up.

What are the next steps for implementing that?

We've implemented our top priorities for what we felt we needed right away, which was nursing documentation—specialized orders for these patients. Then further implementation is really where we're going to get more into best practice advisories. But it's these triggers in [the system we use] that recognize special traits of a patient that's documented on to help providers drive decision making. That's what we'll be doing next.

The challenge there is you don't want to over-notify providers or nurses. So drilling down the very specific patients within the EMR [is important].