IHERO UseCase 2011 FFF

1. Proposed Workitem: Integrated Patient QA Checker (part of Patient Safety Use Case)

• Proposal Editor: Name: Mika Miettinen, mika.miettinen@varian.com, +1 650 799 7665
• Editor: Colin Field for Mika
• Date: N/A (Wiki keeps history)
• Version: N/A (Wiki keeps history)
• Domain: Radiation Oncology

2. The Problem

Current patient QA solutions are not integrated well to the clinical workflow to enable efficient, fast and as automated daily patient QA as possible. The lack of integration causes a lot of manual work for clinicians, and thus does not encourage the adoption of these tools to be part of everyday operations and patient treatments in the clinic.

3. Key Use Case

Success Use Cases

Use Case 1

1. Treatment plan has been created and is sent to Treatment Management System (TMS)
2. Treatment is prepared by dosimetrist in TMS
3. Dosimetrist saves the final plan, and sends it to approval
4. TMS system request a “QA check” from “QA checker” (QA application)
5. “QA checker” performs the “QA Check”, and returns the results to TMS
6. If “QA Checker” result is “Ok to proceed”
   • Plan in TMS is ready to be approved by physicist and physician
   • Physicist and physician approve the plan for treatment
7. If “QA Checker” result is “Not Ok to proceed”
   • TMS informs the dosimetrist about the failure of the check

Use Case 2

1. Therapist opens the worklist on the Treatment Delivery System (TDS) and selects the patient plan to be treated.
2. TDS retrieves the patient plan from TMS
3. TDS system request a “QA check” for the plan from “QA checker” (QA application)
4. “QA checker” performs the “QA Check”, and returns the results to TDS
5. If “QA Checker” result is “Ok to proceed”
   • TDS allows therapist to start treatment (after other verification steps are completed)
6. If “QA Checker” result is “Not Ok to proceed”
   • TDS informs the therapist about the failure of the check and requires QA personnel to resolve the situation.

These are just example use cases, and any actor in the radiotherapy or radiosurgery process shall be able to call a “QA check” at any point of time of the process, and this way the clinic is able to define “QA check timeouts” in their process.

4. Standards & Systems

As IHE-RO addresses interoperability, not functionality, the integration profile must be defined along these lines even if there is a temptation to define what kind of QA checks the “QA checkers” should perform. However it is clear that the community needs the “QA checkers” to perform e.g. data integrity checks, data sanity checks, clinical sanity checks, independent MU calculations, data verification, etc. As part of this integration profile, the technical committee must create a list of “checks” that the “QA checkers” can perform (define what, not how), and what are the expected inputs and outputs in the process.
DICOM RT standard (data objects and worklist) should be considered in implementation of the integration profile. One of the main objectives is to get the QA vendors to join the IHE-RO efforts, and get these QA tools to be part of clinical workflow.

5. Discussion

<Include additional discussion or consider a few details which might be useful for the detailed proposal>

<Why IHE would be a good venue to solve the problem and what you think IHE should do to solve it.>

<What might the IHE technical approach be? Existing Actors? New Transactions? Additional Profiles?>

<What are some of the risks or open issues to be addressed?>

<This is the brief proposal. Try to keep it to 1 or at most 2 pages>