Radiation oncology whiteboard: Data and workflow manager for enhanced communication and task management.

Abstract

304 Background: Patient care within the radiation oncology clinic consists of several interdependent data driven procedures which must be executed in concert to ensure the best possible patient care. State of the art treatment in radiation oncology is largely computer driven, where patient care relies on the use of a typically vendor dependent, heterogeneous server environment. Traditional, peer-to-peer communication in such an environment introduces a fault intolerant workflow, where failed communication and data inconsistency issues may result in delayed or inappropriate patient treatment. Methods: The MGH Radiation Oncology Whiteboard is an intranet based application allowing for live monitoring of these patient care tasks available across the entire radiation oncology clinical domain. Patient events are recorded through interaction from various care-givers and data sources within the department, changing state as well as collecting event data from the accomplished task. Personnel may be alerted of state changes through automatic, customizable paging, email and live monitoring notification, triggering subsequent steps in the workflow chain. Currently the Whiteboard leverages data from multiple points in the clinic including: CT Simulation and data (4D), treatment planning written directive, dvh plan results, imrt and sbrt plan QA, daily and monthly linac QA, IORT coordination and calculation check, linear accelerator engineering log, patient treatment wait time (linac), remote treatment plan review. Results: Since introduction of the Whiteboard into the MGH clinic in 2008, task compliance in key areas, such as contour definition, radiation dose prescription, imrt QA measurement completion and pre-treatment plan checking has risen to levels well above 95%. Conclusions: Monitoring of patient care events improves QA by eliminating peer-to-peer communication and introducing complete transparency to the workflow communication chain. This approach enables all members of the staff to become active participants in the quality control process, every individual, through interaction with the Whiteboard, acting as an additional QC filter to improve patient care.