By: Tyler Blackwell, MS, DABR
Managing a radiation oncology department is complex and requires managing many tasks in parallel: overseeing staff, implementing new technologies or treatment options, accreditation, inspections, financial reports, etc. How do radiation oncology administrators keep their departments running smoothly?
Automation is key. Quickly becoming a clinical staple, automation enables departments to do more in less time, transforming workflows for better quality, safety, and efficiency. Providing staff members with the necessary automation tools is an easy way to ensure top-quality patient care.
Automation From Start To Finish
At virtually every stage of the clinical workflow, more commercial solutions are coming online that accelerate routine tasks. With them come more data that can better inform clinical decisions. They also generate critical time savings that open the door for new treatment offerings such as adaptive planning.
Defining organs-at-risk (OARs) and target structures is time-consuming. While auto-segmentation tools have been available for many years, AI-driven software can dramatically reduce the effort required to produce plan-ready contours. Post-processing of contours can also be streamlined using pre-defined templates to automatically create planning structures like rings, crop structures, and expansions.
When performing quality assurance on contours, using scripted verification templates can reduce the number of potential errors in output structures. These templates standardize routine checks and automate them in the process. They’re capable of catching missing contour slices or extra pixels that may lead to optimization complications or inaccuracies in dose volume histogram (DVH) information.
There is a well-known, inherent variability in treatment plan quality that can depend on individual planner skill levels. By automating portions of this task, including dose constraint entry, optimization, or plan assessment, an opportunity exists to reduce this variability for more consistent plans. Automated planning for field-in-field and electronic compensation plans also has improved plan quality as defined by lower hot spots and better target coverage.
Treatment Evaluation and Review
The plan evaluation step of the workflow is critical for preventing the propagation of errors that could ultimately lead to a treatment deviation for the patient. The number of items suggested for review is vast, according to recent publications such as the American Association of Physicists in Medicine’s TG-275 Report. The report touts the potential of automation in this regard. Some treatment planning systems can access data through various scripting applications, but options for tapping the data are limited unless the staff is well-trained in programming languages. By leveraging automation, templates can instantly compute dose metrics, verify important plan properties and compile comprehensive (but speedy) plan reports.
There are several challenging aspects of ongoing physics review:
The cadence of checks—once per every five fractions—allows errors to potentially remain undetected for several days.
Because of other clinical tasks and competing priorities, weekly chart checks can sometimes be relegated to the end of the day, when physicists may be less attentive to detail.
Manually comparing data from various sources (treatment planning system, record and verify, billing database) can be cumbersome.
Using an automated platform to pull together and compare relevant treatment data, departments now have the ability to monitor treatment data 24/7 in a more intuitive, user-friendly way. Removing the tedious human elements of the review makes the process more effective and less error-prone.
Keeping finances in the black is key to fiscal stewardship and ensures that a department can continue providing excellent care. But with potentially dozens of charges per patient, confusing conflict rules and constantly changing guidelines, errors inevitably manifest. According to a 2019 study done at New York University Winthrop Cancer Center, a whopping 13.6 percent of their patient encounters had some type of billing error. While one-time consulting companies are a great option to help align billing strategies with best practices to help stave off errors, these services cannot ensure ongoing compliance. Automation software can help manage day-to-day codes, detect code conflicts, ensure proper documentation, approval status, and more.
Benefits of Automation
For those that have adopted automated tools, the benefits are clear. Administrators integrating these solutions in their departments see increases in efficiency and throughput and improvements in error rates and standardization. Access to the latest technology offerings allows technical staff to perform at their best to support better patient care.
Radformation is a leader in radiation oncology automation software, offering clinically relevant software solutions to improve efficiency in various aspects of patient care workflows. Leveraging a wealth of clinical expertise, Radformation's goal is to help cancer patients receive treatment faster with safer, smarter radiation treatment plans. From pre-treatment contouring to billing, our team is dedicated to empowering clinicians to improve the patient treatment experience. Learn more at Radformation.com.
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