Quality Assurance with Plan Veto

Quality Assurance with Plan Veto (QAPV) QA check prior to treatment delivery for significant errors.

Summary

This supplement adds the Quality Assurance with Plan Veto (QAPV) profile to the IHE-RO Domain. The QAPV Profile describes the interaction between a Quality Check Requester and a Quality Check Performer that will force evaluation of radiation treatment data to detect and avoid severe treatment errors.

Benefits

Provides check on treatment delivery parameters just prior to actual treatment
Designed to verify on a parameter-by-parameter basis or by quick recalculation of treatment duration
Evaluates treatment delivery data looking for significant errors

Details

Pre-conditions: The profile assumes some Critical Values have been defined on the Quality Check Performer. If the Critical Values have not been defined, the Quality Check Performer should accept the request to create a Unified Procedure Step to do a Quality Check, and will be required to cancel it after an initial subscription has been received. The profile also allows for the Quality Check Performer to indicate other required steps before the interactions described here can be supported. Because of the varied Critical Checks and requirements of different Quality Check Performer products, it would be prudent for Quality Check Requesters to allow for configuration of, and submission to multiple Quality Check Performers for each treatment. It is anticipated that Quality Check Performers will implement models of performing checks which may not be appropriate for all patients at a given site.

Main Flow: The Quality Assurance with Plan Veto profile describes behavior and interactions to augment safety checks during a patient’s treatment in radiation therapy:

The QAPV Check Performer accepts a UPS Workitem for a verification action from a Check Requester
The Check Requester subscribes to updates on the workitem.
The Check Performer actor requests the data specified in the UPS Workitem as required to perform the evaluation. If the data is not available, or deemed insufficient, the evaluation is not performed.
The Check Performer performs the check and prepares the resulting structured report for retrieval by the Check Requester.
The Check Performer updates subscribers on the work that was done, including final state.
The Check Requester gets the Output Information Sequence from the UPS maintained by the Check Performer.
The Check Requester requests retrieval of a structured report from the Check Performer using the SOP Instance and AE Title specified in the Output Information Sequence.
The Check Requester unsubscribes to the workitem.

Post-conditions: The Check Requester allows or prevents the treatment to proceed based on the information found in the structured report. Specific requirements on the treatment approval and override behavior can be found in the supplement.