Supplementary Material for: Specifications of Computerized Provider Order Entry and Clinical Decision Support Systems for Cancer Patients Undergoing Chemotherapy: A Systematic Review

<b><i>Objective:</i></b> Chemotherapy medication errors are catastrophic. The prescription phase in the chemotherapy process plays a key role in the creation of medication errors, and therefore the use of computerized physician order entry (CPOE) and clinical decision support system (CDS) systems is recommended to reduce chemotherapy medication errors. The purpose of this study was to carry out a systematic review on the specifications of the CPOE and CDS systems for chemotherapy prescription. <b><i>Materials and Methods:</i></b> A systematic review on articles published in English up to September 22, 2017, using the 3 databases PubMed, Embase, and Medline was conducted. Those articles that focused on the specifications of CPOE and CDSS in chemotherapy prescription were included in this review. <b><i>Findings:</i></b> Of the 2,471 articles identified, 58 articles met the inclusion criteria and were included in this study. Specifications related to chemotherapy CPOE systems were categorized into the following 6 groups: automation and facilitation of the chemotherapy prescription phase, hospital workflow support, documentation and reporting, drug safety, information security, and system communications. The specifications of chemotherapy CDSS were also divided into 4 categories: embedding chemotherapy protocols, automated dose calculations and adjustment, providing alerts/reminders at the time of prescribing, and guiding or asking the user to complete the important prescription parameters. In 12 articles, the chemotherapy prescription CDSS were designed and evaluated independently of the CPOE; 45 articles provided prescription chemotherapy CDSS as part of the CPOE system, and in 1 article CPOE was introduced with no CDSS. <b><i>Conclusion:</i></b> In complicated settings such as chemotherapy, simplification of the processes is more imperative. The use of chemotherapy CPOE, which includes specifications for helping the medical staff with their workload, encourages the professionals to use such systems and increases the likelihood for success of these systems.

<b><i>研究目的：</i></b> 化疗用药错误后果严重。化疗流程中的处方环节是引发用药错误的关键阶段，因此推荐采用计算机化医师医嘱录入系统（Computerized Physician Order Entry, CPOE）与临床决策支持系统（Clinical Decision Support System, CDS）以降低化疗用药错误风险。本研究旨在针对化疗处方场景下的CPOE与CDS系统规范开展系统综述。<b><i>材料与方法：</i></b> 本研究针对2017年9月22日前发表的英文文献开展系统综述，检索PubMed、Embase及Medline三个数据库。本综述纳入聚焦化疗处方场景下CPOE与临床决策支持系统（Clinical Decision Support System, CDSS）规范的相关文献。<b><i>研究结果：</i></b> 本次检索共筛选出2471篇文献，其中58篇符合纳入标准并纳入本研究。化疗CPOE系统相关规范可划分为以下6大类：化疗处方阶段的自动化与流程优化、医院工作流程支持、文档记录与报告、药物安全、信息安全及系统通信。化疗CDSS规范同样分为4类：嵌入标准化疗方案、自动化剂量计算与调整、开具医嘱时提供警报与提醒、引导用户完善关键处方参数。其中12篇文献将化疗处方CDSS作为独立于CPOE的系统开展设计与评估；45篇文献将化疗处方CDSS作为CPOE系统的组成部分；另有1篇文献仅介绍了CPOE系统，未涉及CDSS。<b><i>研究结论：</i></b> 在化疗这类复杂临床场景中，流程简化更为必要。搭载可减轻医护人员工作负担相关规范的化疗CPOE系统，能够提升医护人员的使用意愿，进而提高此类系统的落地成功率。