LAUSR

Topic Significance & Study Purpose/Background/Rationale CAR T-cell therapy is a complex and novel treatment involving potentially significant safety risks to the patient. The manufacturing companies for each commercial product have stringent FDA mandated safety training and requirements for implementation. Institutions need to identify internal processes that maximize patient safety. Methods, Intervention, & Analysis We developed several electronic medical record (EMR) based processes to enhance safety for our patients. In the EMR, the administration of all CAR T-cell products is documented on a specific flow sheet. The administration flow sheet is included in a CAR T-cell synopsis report consisting of key laboratory tests and assessments. The administration flow sheet drives the patient's EMR header to display the CAR T-cell product's name and days post infusion. Patients who are outpatient receive education to call our on-call team and come to our 24/7/365 Treatment Center. However, if a patient comes to our Emergency Department (ED), we have developed several EMR tools to assist the ED and to notify the on-call team that a patient has presented to the ED. Upon admission to the ED, a banner displays in the ED module of the patient's EMR for patients who received CAR T-cells within the last 90 days. The banner notifies the ED staff to contact the on-call team and lists specific CAR T-cell side effects. At the same time, the on-call provider pool receives an automated in-basket message and pager alert via the EMR. Findings & Interpretation These EMR tools have helped identify patients who received CAR T-cell therapy at our institution. The ED automated alerts have fired four times since implementation. This has allowed the on-call team to meet the patient in the ED and assist the ED team to assess and care for the patient. Discussion & Implications CAR T-cell therapy presents unique side effects for patients that may mimic other medical conditions. Tools built into our EMR have enhanced safety for our patients and allows us to deliver extraordinary care to recipients of this novel therapy. These EMR processes would be helpful to other centers performing or considering CAR T-cell therapy.