By Mary Feng, MD, Department of Radiation Oncology, University of California San Francisco, and Björn Hårdemark, MSc, RaySearch Laboratories AB, Sweden
Radiation oncology is a highly specialized field in which dozens of complex hardware and software systems are needed to provide the best possible care. Within these systems, information is exchanged and if these exchanges are not clearly defined, the safety and efficiency of clinical care can be compromised. To address this issue, ASTRO created Integrating the Healthcare Enterprise-Radiation Oncology (IHE-RO) in 2004, as an initiative that helps to ensure safe, efficient radiation treatments by improving system-to-system connections.
IHE-RO, now operated by the American Association of Medical Physicists (AAPM) in collaboration with ASTRO and other organizations, is composed of physicists, physicians, software engineers and others from private practice, academics and industry, working together to identify and solve connectivity issues in radiation oncology. To assess and prioritize what technical challenges are most pressing to the radiation oncology community, biennial surveys are conducted of ASTRO and AAPM members. This feedback is used to develop new use cases, which are the basis for the technical committee to develop industry standards for vendors to improve the system integration of their products, resulting in safer and more efficient patient care. Vendors can meet in annual Connectathons to test the success of product development and their ability to integrate with other hardware and software.
In the latest biennial survey, 295 responses were submitted by individuals from six continents. Of those surveyed, 67% reported difficulties with specific clinical workflows due to systems not working well together and entered up to three specific interoperability issues. Not surprisingly, common themes and issues emerged. These items were reviewed by the technical committee and categorized as the following:
- Challenges with oncology information system (rad onc OIS) and health information system interfacing (HIS).
- Challenges with oncology information system and treatment machine integration.
- Software features of individual products or classes of products.
Poor interoperability between radiation oncology and health information systems was noted as a frequent challenge, resulting in potentially degraded quality and efficacy of clinical care. In the past year, IHE-RO has already been defining the problem and developing testing tools, which we anticipate making available in the coming year, so that vendors can initiate software enhancements to facilitate data sharing, supporting ASTRO’s Minimum Data Elements initiative.
Based on the most recent survey, new use cases for the coming year include:
- Information transfer (including dose, shifts and imaging data) from the treatment machine to the oncology information system for treatment dose verification.
- Radiation simulation scan and spatial dose information transfer to Radiology PACS to assist in tumor response/toxicity assessment and subsequent patient care.
- Beam data file format standardization for more efficient commissioning of treatment planning systems and machines.
IHE-RO is a partnership between end users in the clinic and vendors, all working together to advance patient care in a safe and streamlined way. Please share your clinic’s interoperability issues with us so that we can help. Visit the IHE-RO webpage for more information.