patterns, especially with tens of generic drugs now
widely available in the Egyptian market;
‰ treatment schedules coordinate for maximum savings;
‰ ability to calculate administration time, hence a better
scheduling that avoids overcrowding of patients in
administration rooms, for a better and more humane
service;
‰ prevention of administrative errors by improving and
standardizing information transmission from physician
to clinical pharmacists to nurses;
‰ professional patient and paper administration flows;
‰ dedicated statistical data collection team;
‰ affiliated clinical research unit (CRU) nucleus: currently
an upgrade is ongoing to reach a national and
internationally accredited research unit funded by a
pharmaceutical grant. The CRU even in its basic form is
currently attracting multinational phase III/IV oncology
clinical trials. We are aiming to increase our share of
international clinical trials participation, advancing to
other phases/variants of studies and to harmonizing the
department with home grown research;
‰ the development of this unit has attracted many fresh
graduate clinical pharmacists to perform their training
stages there.
All this has allowed us to increase our performance,
rapidity of service, readjust medication usage and to plan for
a more advanced evaluation of the computerized data that is
now available.
The development of a whole department oncology
electronic medical record
Problem: The available medical records system is still an old
fashioned hard copy file system, housed in an archive room
that no longer fits the large number of files. This has led to
the loss of a quantity of valuable information and patient
discomfort due to increasing waiting times for their file
retrieval. Moreover, data collection is not standardized (but
based on individual experience) and statistical analysis
requires a huge amount of effort to go through the files.
Furthermore, the installation of different EMR systems in
other departments had failed due to the large number of
patients seen per day and a lack of experienced personnel
for data entry, which is more time consuming than the
conventional paper system.
Solution: We customized a solution for an EMR system
which consisted of:
‰ Customized sheets specifically designed for oncology
REGIONAL INITIATIVES
122 CANCER CONTROL 2015
patients' data, with multiple tools to decrease doctors
time spend on data entry:
- automatic guide for ICD-O and ICD-10 codes;
- automatic chemotherapy regimen dose calculation;
- CTCAE and RTOG toxicity guide.
‰ The project not only comprised the EMR programme, but
also improvements to the infrastructure through:
- a network system;
- computerization of the clinics and data entry rooms;
- cover from two data entry personnel, with medical
backgrounds, who can enter the data into the
medical records in their appropriate fields in the EMR.
‰ The development of such a programme allows for a rapid
retrieval of masses of information about actual disease
rates, survivals, and the actual needs as regards
treatment machines and drugs.
‰ Big data-driven research.
Radiotherapy e-learning programme
Problem: One of the important challenges that faces
oncology in developing countries is the lack of knowledge
and the deficiency of experienced personnel. In
radiotherapy, it's a more pressing problem due to price of
technology related to it, the diversity of specialties involved
in the treatment process and the "migration of minds" to
developed countries (7). The access to foreign educational
courses and e-learning programmes are usually quite
expensive for low- and middle-income countries.
Solution: The migration of experienced personnel is actually
an opportunity that can be used in "cheap" e-learning
modules. This has led to the initiation of a teaching
programme project in cooperation with our previous
faculties that are now working in United Kingdom, France
and the United States.
The low-cost web-based e-learning platforms are under
evaluation for radiotherapy delineation and contouring
courses. There is still a lack of educational programmes
delivered to technicians, dosimetrists and physicists. In this
setting, we are trying to deliver local training, but
international e-learning modules still need to be
implemented.
Radiotherapy infrastructure
Problem: The lack of infrastructure is a common problem in
low- and middle-income countries. When it comes to
radiotherapy machines, the issue is exponentially more
complicated when it comes to machine acquisition,
operation and maintenance. We have in our department one