Applying a Web-based Integrated Radiation Oncology Information Platform to Enhance Working Efficiency and Increase Patient Safety

Abstract

Radiotherapy (RT) workflow combines multidisciplinary teamwork, including radiation oncologists, medical physicists, therapeutic radiologists, and oncologic nurse. It is a complicated multi-step process, which requires strict quality control and standard operation procedures to prevent medical errors. In addition, most cancer patient are vulnerable and relatively immune-compromised, especially those received current chemoradiotherapy. Herein, we established a web-based Integrated Radiation Oncology Information Platform (IROIP) to grasp data from several independent information systems, such as Health Information System (HIS) and Radiotherapy Information System (RIS). This integration demonstrated a real-time manner, resulting in a more effective way to enhance treatment efficacy and increase patient safety. Staff safety was also guarded during RT via preventing intra-mural infections. To effectively integrate data from different independent information systems, we established a web-based IROIP. IROIP had several user-oriented functions, creating a high utility fluency (>10,000 person-times use per year in a 30-staff RT department). Two example functions were as follows. First, IROIP was able to set e-controls in each RT workstation, such as simulation, target delineation, and treatment planning. Automatic alerts could be prospectively defined. Second, IROIP was able to automatically alert medical abnormal data before each RT treatment, such as low white blood cell count (WBC) or tuberculosis (TB) infection. This allowed immediately intervention and prevented severe adverse events, such as septic shock and intra-mural infection. After implementing e-control of IROIP, the overall processing time of pre-RT workflow was shortened from 12.2 days to 8.9 days (P < 0.001). After online use of automatic alert of IROIP for patients’ abnormal data before each RT treatment, the rate of developed severe leukopenia was decreased from 94% to 58% (P < 0.001). More notably, the intra-mural infection rate was also decreased from 26.1% to 6.7% (P < 0.05). Remarkably, by using IROIP, the processing time that required for pre-RT “time out” to check laboratory data was significantly reduced from 40 min to <1 min (per 100 patients per day). In our experience, establishing and applying an integrated information platform are useful in not only effectively integrating data from different information systems, but also alert abnormal medical data to allow immediately intervention. These abilities enhanced working efficiency and increased patient safety. Further parallel expand and investigation are encouraged.