Healthcare Inspection Electronic Ordering of Chemotherapy Fargo VA Medical Center Fargo, North Dakota

The purpose of this review was to determine the validity of allegations a complainant made to the OIG Hotline Section regarding unresolved software problems with the electronic ordering of chemotherapy at the Fargo VA Medical Center (the facility), Fargo, North Dakota. The complainant specifically alleged that a patient received an increased dose of chemotherapy because of software problems with the recently installed electronic ordering program (IntelliDose®), and the dosage side effects required the patient to be admitted to the intensive care unit. We substantiated that staff pharmacists were uncomfortable verifying IntelliDose® chemotherapy orders. When staff pharmacists were required to check patients’ clinical data, validate chemotherapy dosage, and sign-off orders prior to dosing, pharmacists began voicing concerns to managers. No single pharmacist was assigned responsibility for chemotherapy and the duties were rotated, leaving pharmacists with gaps in actual hands on experience. The Chief of Staff responded to concerns and instructed staff that oncologists would assume all responsibility for verifying dosages of chemotherapy.