Implementing a regional oncology information system: approach and lessons learned

  • W.K. Evans McMaster University
  • F.D. Ashbury Intelligent Improvement Consultants, Inc.
  • G.L. Hogue Insightful Solutions
  • A. Smith ADS Consulting Solutions
  • J. Pun Intelligent Improvement Consultants
Keywords: electronic medical records, oncology information systems, implementation



Paper-based medical record systems are known to have major problems of inaccuracy, incomplete data, poor accessibility, and challenges to patient confidentiality. They are also an inefficient mechanism of record-sharing for interdisciplinary patient assessment and management, and represent a major problem for keeping current and monitoring quality control to facilitate improvement. To address those concerns, national, regional, and local health care authorities have increased the pressure on oncology practices to upgrade from paper-based systems to electronic health records.


Here, we describe and discuss the challenges to implementing a region-wide oncology information system across four independent health care organizations, and we describe the lessons learned from the initial phases that are now being applied in subsequent activities of this complex project.


The need for change must be shared across centres to increase buy-in, adoption, and implementation. It is essential to establish physician leadership, commitment, and engagement in the process. Work processes had to be revised to optimize use of the new system. Culture change must be included in the change management strategy. Furthermore, training and resource requirements must be thoroughly planned, implemented, monitored, and modified as required for effective adoption of new work processes and technology. Interfaces must be established with multiple existing electronic systems across the region to ensure appropriate patient flow. Periodic assessment of the existing project structure is necessary, and adjustments are often required to ensure that the project meets its objectives.


The implementation of region-wide oncology information systems across different health practice locations has many challenges. Leadership is essential. A strong, collaborative information-sharing strategy across the region and with the supplier is essential to identify, discuss, and resolve implementation problems. A structure that supports project management and accountability contributes to success.

Author Biography

F.D. Ashbury, Intelligent Improvement Consultants, Inc.
Fredrick Ashbury is Principal Consultant and Co-Founder of Intelligent Improvement Consultants. Inc. He has 19 years experience in behavioural research and program evaluation in health and education. He earned his doctorate at York University, Toronto, Ontario. Dr Ashbury has held senior positions in the following organizations: PAE Research, Workers’ Compensation Board of Ontario, National Cancer Institute of Canada, OpTx Corporation, Bridgesite Clinical Research, Inc., and CAREpath Research Institute. Effective January, 2009, he will be Editor-in-Chief of the international, peer-reviewed journal, Supportive Care in Cancer.

His research interests include cancer prevention (primary and secondary), cancer patients’ experiences at point-of-care, including physician-patient interaction/communication, patient quality of life and supportive care, intervention research and program evaluation.. Dr Ashbury consults to government, not-for-profit and private sector organizations in Canada, the US, Germany, Australia and the UK. He holds an academic appointment at the University of Toronto, in the Department of Health Policy, Management and Evaluation. His previous university appointments include McGill University, the University of Manitoba, the Ontario Institute for Studies in Education, and Guelph University. Dr Ashbury has, with his colleagues, received funding from leading granting agencies, foundations and pharmaceutical company sponsored studies in Canada and the US. Dr Ashbury has published and presented more than 65 papers in peer-reviewed scientific journals, scientific abstracts, book chapters and public documents. He is a collaborating author on the book, Opportunity and Uncertainty: Life Course Experiences of the Class of ’73. He is a member of the board of directors of the Childhood Cancer Foundation (Candlelighters) Canada, and is a member of the National Medical Advisory Board of CAREpath Inc. He also served for 10 years as a director of the Canadian Association of Psychosocial Oncology. Dr Ashbury is a member of numerous professional organizations, including the American Society of Clinical Oncology, the Canadian Association of Psychosocial Oncology, American College of Epidemiology and the Multinational Association of Supportive Care in Cancer.

How to Cite
Evans, W., Ashbury, F., Hogue, G., Smith, A., & Pun, J. (2014). Implementing a regional oncology information system: approach and lessons learned. Current Oncology, 21(5), 224-233.
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