A Radiation Oncology Based Electronic Health Record in an Integrated Radiation Oncology Network

Purpose: The goal of this ongoing project is to develop and integrate a comprehensive electronic health record (EHR) throughout a multi-facility radiation oncology network to facilitate more efficient workflow and improve overall patient care and safety. Methodology: We required that the EHR provide pre-defined record and verify capability for radiation treatment while still providing a robust clinical health record. In 1996, we began to integrate the Local Area Network Treatment Information System (LANTIS®) across the West Penn Allegheny Radiation Oncology Network (currently including 9 sites). By 2001, we began modifying and expanding the assessment components and creating user-defined templates and have developed a comprehensive electronic health record across our network. Results: In addition to access to the technical record and verify information and imaging obtained for image-guided therapy, we designed and customized 6 modules according to our networks needs to facilitate information acquisition, tracking, and analysis as follows: 1) Demographics/scheduling; 2) Charge codes; 3) Transcription/clinical documents; 4) Clinical/technical assessments; 5) Physician orders 6) Quality assurance pathways. Each module was developed to acquire specific technical/clinical data prospectively in an efficient manner by various staff within the department in a format that facilitates data queries for outcomes/statistical analyses and promotes standardized quality guidelines resulting in a more efficient workflow and improved patient safety and care. Conclusions: Development of a comprehensive EHR across a radiation oncology network is feasible and can be customized to promote clinical/technical standards, facilitate outcomes studies, and improve communication and peer review. The EHR has improved patient care and network integration across a multi-facility radiation oncology system and has markedly reduced the flow and storage of paper across the network

Revisions in Nepenthes following explorations of the Kemul Massif and the surrounding region in north-central Kalimantan, Borneo.

An expedition to the highest peak of the Kemul Massif located a number of different Nepenthes taxa, including the type populations of N. fusca Danser and N. mollis Danser (Nepenthaceae), neither of which have been observed in situ since they were first collected from Kemul in 1925. Studies of the type form of N. fusca show that N. fusca s.lat. includes two other species, one largely restricted to Sabah’s Crocker range, here reinstated as N. zakriana (J.H.Adam & Wilcock) J.H.Adam & Hafiza, and a more southerly distributed species from Brunei, Sarawak and Kalimantan, named here as N. dactylifera A.S.Rob, Golos & Barer. Analysis of the type population of N. mollis indicates that N. hurrelliana Cheek & A.L.Lamb is a heterotypic synonym of N. mollis, and reveals an additional undescribed Nepenthes species from Sarawak and Kalimantan with a widespread but highly localised range