Radiation Oncology: Opening the Doors to IT

Accessing patient charts

The radiation oncology department at Alexian Brothers Medical Center, a 320-bed, acute care hospital in Elk Grove Village, Ill., uses IMPAC Medical’s Mosaiq electronic medical record (EMR) for the accessibility of patient charts.

The scheduling, billing, management reporting and analysis tools in Mosaiq enable more efficient treatment management, according to Christy Kesslering, MD, medical director, radiation oncology.

The chart is a vital component to managing patient treatment,” she says. “The charts must be accessible to everyone involved.”

The ability to track a chart means “things do not fall through the cracks as easily.” Every time an order is filled or an appointment is booked, the appropriate person is automatically notified. On-call physicians can access information off-site.

“Everyone can see where the patient is in a course of treatment,” Kesslering adds. Security settings can be altered to limit access so that a dosimetrist cannot write or change a treatment field and, in turn, a physicist cannot write a prescription.

Getting equipment from different vendors talking with EMR systems is a challenge, she says. Alexian has experienced some issues when installing new imaging systems that “do not talk to the EMR.”

“This certainly seems to be an area where there is a delay,” Kesslering says. “In this case, we have to separate charts for patients.”

For example, the department’s TomoTherapy Hi·Art treatment system does not have record and verify capabilities within Mosaiq. Treatment information sits in the machine’s EMR, while the clinical information is in the department’s EMR, requiring manual and on-site image retrieval, she says.

Unifying disparate systems

The University of Texas M.D. Anderson Cancer Center in Houston, which will see more than 79,000 oncology patients in 2008, installed TeraMedica’s Evercore Oncology Information Manager integrated with IMPAC Medical Systems, Multi-ACCESS EMR, across its radiation therapy clinics, satellite facilities and Proton Therapy Center to combat high patient volume.

Evercore collects radiation oncology and radiation therapy information from a diverse range of disparate equipment and, with access through the IMPAC EMR, acts as the center’s central DICOM data repository and image management system.

“We have treatment plans developed on systems that were propriety that we are no longer using and we want that information,” says Michael T. Gillin, PhD, head of clinical physics, department of radiation physics. “The goal is to translate, transfer and use the information with Evercore.”

Gillin says that radiation oncology is moving toward a more interconnected arena with IT.

“Radiation is now doing what radiology did—we have no choice,” he concludes. “The traditional ways we used to deal with this problem just don’t work anymore.”

Minimizing errors

Doctors Hospital in Augusta, Ga., uses fully integrated technologies from one vendor to treat approximately 45 cancer patients daily in its Radiation Oncology Center.

The hospital needed to purchase a second linear accelerator yet wanted a full system  integration, which they found with Varian Medical Systems. The department uses Varian Trilogy linear accelerators, the Aria Oncology Information System and the Eclipse treatment planning system.

“Prior to Varian, transfers were made from the treatment planning system, to the third-party information system, to the Varian treatment machine,” says Physicist Stephan Terry.

Lynn Dixon, chief medical dosimetrist and manager, radiation oncology, says Aria aggregates patient data into a single, organized, oncology-specific medical chart, allowing for effective treatment management for patients.

“Eclipse has eliminated what was once several steps for transferring information from one workstation to another,” says Dixon.

Terry says that until EMRs are rigorously tested for error rates or delays, the adoption of IT solutions within the field may still be slow, due to the sensitivity of information and the need to constantly check treatment plans.