We want to share a few of our contouring tips and tricks that our team developed in the clinic.
Celebrating Big Milestones with Todd Bernath
To celebrate working with over 1,000 clinics worldwide, we look back and reflect with our very first customer.
But a journey of this magnitude starts small. New ventures and new products often have little background information or no history to go on, so discerning dosimetrists and physicists may be skeptical of new tools. But you have to start somewhere. And this is why we’re so pleased to chat with Todd Bernath, MS, DABR, as he was the very first to sign on with ClearCheck. In our short chat, we reminisce about the early days of Radformation and why he committed early.
Tyler Blackwell: Hi everyone. I’m Tyler Blackwell. I’m a physicist with Radformation, and I’m joined today by physicist Todd Bernath of Wright-Patterson Air Force Base in Dayton, Ohio. It’s a really special time for us right now at Radformation. We’re on the verge of our fifth birthday, the company’s fifth birthday, which is coming soon. And we recently celebrated a major milestone. Our software is now installed in over a thousand clinics across the country and scattered throughout the globe. And this is a really big deal to all of us. So when we reflect on the clinical impact of the tools that we’ve designed, it brings us a lot of joy.
But these kinds of journeys start small. And new ventures, new products…they sometimes have little background information to go on. So discerning physicists and dosimetrists may be skeptical of new tools, But you have to start somewhere. And this is why we’re so pleased to have Todd Bernath join us today as he was the very first to sign on with our first product ClearCheck. So thank you so much for being that person, todd.
Todd Bernath: You’re welcome. You’re welcome. Thanks for having me.
Tyler Blackwell: Yeah. So I wanted to ask you a couple of questions to kind of celebrate you and celebrate the installs. Did you know you were the first person to commit to the brand new product?
Todd Bernath: No, not for a while. I think it was a couple of years after. We were at an annual meeting and Radformation was having an event, and Kurt [Sysock] and those guys, Liz [Van Wie], I think they let me know that I was the very first customer. So I knew I was an early adapter. I wasn’t sure who signed on the dotted line first, but yeah, I did eventually find out that we were the first customer. So I’ve lived that up ever since.
Tyler Blackwell: You need a badge, right? So every time you go to the AAPM, you need that little badge.
Todd Bernath: That’s right. The number one.
Tyler Blackwell: That’s awesome. Well, ClearCheck was completely brand new. Radformation as a company was brand new and there was no track record for either one. So what convinced you to move forward with ClearCheck and with Radformation?
Todd Bernath: Well, it was exactly what we were looking for. We were a multiple-site clinic and we had doctors at multiple locations. We had dosimetrists at multiple locations and we were trying to come up with an idea how to, during your plan review, give the physicians the numbers they needed to operate in a busy practice and stay on a specific timeline for the planning process. And I had actually dabbled in—or was trying to dabble in—a little bit in scripting. I knew a little bit about it, and I knew the potential that there was. I knew Pinnacle had used some scripting, but I wasn’t really familiar with anything that Eclipse had on board. And I was just walking through AAPM one year and I saw this tiny little booth on the corner, one of those low rent district booths.
Todd Bernath: And just three people in there. I think it was Liz and Kurt and Alan [Nelson] who were the only three in the company at the time. So I stopped in and at that point, it was just ClearCheck and it was like a light bulb. It was exactly what we were looking for. It was something that we could customize for our physicians based on the treatment site, number of fractions. Something that the dosimetrist could easily set up on their own. Review a plan, if they needed to make adjustments, they could relaunch ClearCheck multiple times as needed as quickly as they needed.
Todd Bernath: And that was it. I wouldn’t have written it any better. So that’s exactly what we had in mind. So once I saw that and saw the demo, it didn’t take long to convince the people in our practice that that’s what we needed for efficiency and for accuracy. Dealing with the Eclipse DVH cursor got to be mind-numbing at times. So this is, when you’re just talking about one or two specs, that’s fine. But when you’re talking about multiple, especially when you get into SBRT and TG101 specs, it’s a lot to process manually. And this does the trick for sure.
Tyler Blackwell: Yeah. When Varian opened up the ability to script your own constraints, that sort of created this demand within clinics to do more constraints. Hey, if you can script this, why doesn’t the physicist just create his or her own and automate more of this? Well, it just seemed like Radformation was right there to provide what you needed at the right time.
Todd Bernath: Yeah, it was. I mean, the data was already there. It’s just a matter of mining it out and putting it in a nice, clear, concise format for us.
Tyler Blackwell: So having worked with them then afterward, what did you learn about Radformation in the process and what surprised you about Radformation or ClearCheck along the way?
Todd Bernath: I mean, I guess it was designed by people just like me, just clinical physicists that know what we need and what we use and, and what we don’t need. And so many times you get products that are so layered with, why did they put this in there and why did they take this out? I don’t know how many times that we go from one version to another in the software and we’re wondering why did they just leave that in there that was something? And so with, the first time I met Kurt, Alan, and Liz, and they showed me the product and they spend a lot of time with me and they were just a bunch of physicists who had a great idea and put all their minds together and did what clinically what we need to have done.
Tyler Blackwell: Yeah. So you originally, it sounds like you had at first used ClearCheck for kind of basic constraints. Did your use of ClearCheck evolve over time at all?
Todd Bernath: Yeah, it did. When we started simple, well, I shouldn’t say simple. We started with just, we kept it to SRS and SBRT cases, cases that just had multiple kinds of published constraints, TG101, some SRS protocols, stuff that you guys actually provided for us. That’s another thing to mention, the template library that you guys provide is amazing. So we started with those and we just kind of grew from there. We started building our own in-house templates and for just even 3D plans and all different areas of treatment. And then we redid our structure templates within Eclipse, the naming convention to match the naming convention that was within the ClearCheck templates. So when ClearCheck was launched for the first time, the structures automatically assigned themselves to the templates rather than the dosimetrists having to go through the drop-downs and pick. And we didn’t have to assign any aliases.
Todd Bernath: So that was kind of our process. And then you guys continued to come out with features, collision check, structure check was a big one for us. We’ve got some physicians who like to draw, erase, draw, erase, and you never know when there’s that little pixel out there hiding somewhere. And we’ve had issues with stray pixels in dose, and they’re very hard to see on the CT slices. So we started using structure check to find those stray pixels, which has been great.
Todd Bernath: And then probably one of the biggest things you guys did for us was the report templates. We were using the report templates that came just standard within Eclipse, and they can be very busy. So when you guys came out with your report templates that were a big game-changer for us and our EMR system, because like I said, we had multiple dosimetrists and multiple positions, and everybody did things a little bit differently when you had to go into Eclipse manually and come up with your own document and with report template we were able to clean it up, customize it exactly how we wanted it, the order of what we wanted it. You can add all the structure checks in there.
Todd Bernath: You can add, obviously the ClearCheck templates in there. You can add isodose views, all three planes, and it’s really a one-click process for the dosimetrist. And when you work with like, we do a third-party EMR, that one concise PDF was great for us to just save it as a PDF and then import it into our third-party EMR. So as great as ClearCheck has been for us, and it’s been phenomenal, I would say second in line to that was just the report templates, just how customizable they’ve been and how clear and concise they are. So those have been really, really great for our practice.
Tyler Blackwell: Yeah, no report building is a major effort for anyone in the department. And it’s something that just takes a lot of time and it’s a bit tedious. So, I mean, I think it’s really great to hear how you guys got on early with this, but then as features rolled in, you guys took advantage of everything and made inroads for efficiency in a number of different spots. So it was good to hear. I love it.
Todd Bernath: Yeah.
Tyler Blackwell: But it sounds like recently you moved on to a new job. Is there anything you wish you could have brought from your former clinic?
Todd Bernath: Well, ask me in a few weeks. So definitely ClearCheck for sure. We’re not as busy in the clinic, but there’s certainly a need for us. We still have the same plan evaluations that all clinics busy or not busy use. So from an accuracy standpoint, the wheels are in motion for us to do ClearCheck at my new clinic. So I’ve already got the quotes I need for ClearCheck, EZFluence. So yeah, those will definitely be incorporated into my new clinic.
Tyler Blackwell: Yeah, when you get used to something it’s like pulling the rug out from underneath.
Todd Bernath: That’s right. That’s right back to using, it’s hard to go back to using Excel spreadsheets to report out your constraints.
Tyler Blackwell: Yeah, well, what a pleasure to chat with you, Todd, and to hear your perspectives and being the first person to purchase ClearCheck. I mean, it’s just what a cool honor to chat with you. So I want to thank you for your time and more importantly, thank you for the trust you had and have with Radformation. It means the world to us.
Todd Bernath: No, it’s been a great product. It’s very reliable, support has been great. I’ve never had an issue with installations. Somebody is always just a phone call away. So you guys have been great.
Tyler Blackwell: Thank you so much. Take care.
Todd Bernath: Appreciate it. All right. Thanks.
Written by Tyler Blackwell
Tyler is a board-certified medical physicist with extensive clinical experience in radiation therapy. He is active in several AAPM committees, has served as secretary-treasurer for the Northwest Chapter of AAPM, and is an ABR orals examiner. Tyler dabbles in real estate investing and loves preparing breakfast for his three kiddos.
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