This past year has been a whirlwind. I’ve gone from practicing in Montana to spending time in West Virginia, and now I’m transitioning back to Orlando Florida, two months earlier than when I had expected. I’ll be working with a Florida Cancer Specialist clinic in Orlando where they needed urgent coverage. Sincere appreciation to Orlando Health and Dr Rafael Manon for allowing the non-compete exception. It’s been fun and a little surreal — reconnecting with familiar faces in unexpected ways. Just recently, I saw the mother of one of my former patients in clinic. Her daughter, my former patient, came along and reminded me of our time together years ago and who’s doing extremely well today. It was a full-circle moment — a reminder that in oncology, relationships with patients and families often extend far beyond a single diagnosis.
The coincidences didn’t stop there. Same day, I stepped out for sushi lunch near clinic and ran into an old BMT/research colleague, sitting a few tables away. It felt like stepping back into a familiar rhythm — like the universe was telling me I was truly back home.
But in between these meaningful encounters, one of the biggest lessons of this past year has come from a much less glamorous part of oncology: learning and re-learning electronic medical record (EMR) systems. Moving between three different EMRs in rapid succession — Epic, Cerner, and OncoEMR — has been both a challenge and an education. Each system brings its own quirks, strengths, and frustrations. Each system is like learning a new language.
Here’s how I see them, from the perspective of an oncologist who has lived with each one.
Ease of Use
Epic remains the most intuitive. Coming back to it after years away felt natural, like riding a bike. OncoEMR was surprisingly easy to pick up — within 24 hours I was up and running, while apparently per the nurses other providers took weeks to get up to speed. Cerner, by contrast, felt clunky, with too many layers and unnecessary menus.
Winner: Epic (#1), OncoEMR (#2), Cerner (#3).
Workflow Integration for Oncology
OncoEMR gets this one. For chemotherapy workflows, it’s seamless: choose an indication, pull up the regimen, adjust as needed, and sign. Epic comes close, with strong lab integration and multidisciplinary coordination. Cerner lags behind, where at times I had to rely on pharmacists to enter chemotherapy orders because the system was too cumbersome.
Winner: OncoEMR (#1), Epic (#2), Cerner (#3).
Chemotherapy Regimen Management
Again, OncoEMR shines here. Regimens are easy to find, modify, and sign off quickly. Epic is a close second with robust order sets, but Cerner again relies too heavily on workarounds and additional staff input.
Winner: OncoEMR (#1), Epic (#2), Cerner (#3).
Communication Tools
I’ll be honest — I avoid using EMR messaging whenever possible. With Epic, Cerner, and OncoEMR, the messaging platforms all generate an overwhelming flood of notifications that bury the important notes under the noise. I prefer direct channels — phone, email, or my clinical team triaging messages for urgency.
Winner: None.
Speed & Efficiency
Speed matters. Epic and OncoEMR both deliver quick, responsive performance. OncoEMR might edge slightly ahead in responsiveness, but Epic is very close. Cerner, on the other hand, feels sluggish, with delays that add up when multiplied across dozens of encounters a day.
Winner: OncoEMR (#1), Epic (#2), Cerner (#3).
Customization & Flexibility
Epic leads here. It allows for tailoring templates, order sets, and notes to match a physician’s workflow. OncoEMR has some customization but is more limited. Cerner feels rigid and less adaptable.
Winner: Epic (#1), OncoEMR (#2), Cerner (#3).
Data Visibility
In oncology, seeing the big picture — labs, pathology, imaging, prior notes — is critical. Epic organizes this information most clearly, with OncoEMR not far behind. Cerner makes finding key information unnecessarily difficult.
Winner: Epic (#1), OncoEMR (#2), Cerner (#3).
Technical Reliability
Epic and OncoEMR are both stable, with minimal lag or downtime. Cerner, again, feels slower, though still preferable to some older systems I’ve used in the past (like Sunrise).
Winner: Epic & OncoEMR (tie), Cerner trailing.
Overall Value for Oncology Practices
If I were advising a cancer center or hospital system, I’d recommend Epic. It’s widely adopted, integrates smoothly with other Epic sites (giving instant access to outside records), and balances customization with workflow efficiency. OncoEMR is also a solid contender — especially for community practices that need a streamlined oncology-specific solution. Cerner, in my experience, lags significantly in usability, efficiency, and oncology support.
Final Verdict:
- Epic – Best all-around, especially for large systems.
- OncoEMR – A close second, excellent for oncology-specific workflows.
- Cerner – My least favorite; functional but clunky and inefficient.
Switching EMRs multiple times in a single year has reminded me that technology can either amplify or undermine the practice of medicine. The right EMR reduces cognitive load, integrates seamlessly into workflows, and supports safe, efficient cancer care. The wrong EMR becomes a daily frustration — an invisible barrier between physician and patient.
Looking ahead, I’m particularly interested in how artificial intelligence (AI) will be (and has been) incorporated into EMRs. The promise is not just smarter automation, but better alignment with what matters most: improving patient outcomes and quality of care, while also protecting the quality of life for physicians and healthcare providers. If AI can help streamline documentation, anticipate clinical needs, and minimize the constant burden of clicks, then EMRs can finally evolve from a barrier into a true partner in care.
As institutions weigh their options, they should consider not only cost and IT infrastructure, but also the physician experience. Because ultimately, the best EMR is the one that lets us spend less time clicking and more time caring. I do look forward to using Epic again… starting December 1st at Advent Health Cancer Institute downtown Orlando
About the author
Dr. Sajeve Thomas is a distinguished medical professional and a compassionate guide in the field of oncology. With over a decade of dedicated experience as a board-certified medical oncologist/internal medicine specialist, Dr. Thomas has become a trusted expert in the treatment of melanoma, sarcoma, and gastrointestinal conditions. He brings a wealth of expertise to the complex and challenging world of oncology.
Disclosures:
Dr. Thomas serves as a speaker for Bristol Myers Squibb (BMS), Merck, Ipsen, Natera, Immunocore, Pfizer, and SpringWorks. He also receives industry grants in support of numerous clinical trials.