Expanding Automation Across the Treatment Planning Workflow

"We were early adopters of Radformation’s EZFluence, and quickly recognized the significant benefits that automation could bring to our workflow, particularly in terms of ease of use and efficiency."

This month, we’re excited to highlight Jonathan Dysart, Ph.D. mCCPM, Chief Medical Physicist at Saint John Regional Hospital Oncology Department in New Brunswick, Canada. The team at Horizon Health includes four dosimetrists, five medical physicists, and six radiation oncologists, the largest tertiary care facility in the province. Collectively delivering about 1,200 radiation treatment plans annually, the team at Saint John’s offers advanced techniques for their patients, such as cranial SRS.

Jonathan’s journey with automation was initially driven by his experience with in-house developed software and scripting. Given their small development team, they explored commercial solutions to improve efficiency in treatment planning, and became early adopters of EZFluence in 2019. “We quickly recognized the significant benefits that automation could bring to our workflow, particularly in terms of ease of use and efficiency,” Jonathan shared. EZFluence proved so beneficial that it became a staple for nearly all non-VMAT plans at their center.

Not long later, Jonathan’s team expanded their automation toolkit. “Building on this success, we expanded our use of automation tools in 2021 by integrating Limbus Contour (part of the Radformation lineup as of 2024) for auto contouring,” he explained. In early 2024, they doubled down on automation and added ClearCheck and ClearCalc to their workflow. These tools brought “remarkable gains in efficiency,” allowing the team to focus more on high-quality treatment plans and less on routine checks and report generation.

The introduction of ClearCheck and ClearCalc marked a significant shift in the department’s workflow. Jonathan details, “We rolled out the adoption in three phases over a 3-month period, with appropriate user training at each step.” The efficiency boost was evident across the board for dosimetrists, physicists, and oncologists. “All our users quickly realized the benefits,” he added, commending Radformation’s support staff for their training sessions and responsive assistance. After full implementation, Jonathan’s team eliminated three steps from their treatment planning care paths. “Using ClearCheck is now second nature.” 

While ClearCheck and ClearCalc’s primary appeal was automated plan checking and a streamlined second dose check, the team found additional unexpected advantages. “We’ve been impressed by the included clearance check, as this has caught numerous instances of potential collisions, avoiding the need for replanning once the plan has reached the patient,” Jonathan shared. The customized reports generated by ClearCheck, which include second dose checks and portal dosimetry results, are sent directly to ARIA, further boosting efficiency.

Jonathan also praised the Chart Rounds module in ClearCheck, which they use for weekly group review sessions. “This provides a much improved and more streamlined interface than accessing each plan review directly through Eclipse,” he noted.

By embracing automation, Jonathan and his team have made significant strides in improving both efficiency and patient care in their department. Their journey shows just how impactful the right tools can be—helping streamline workflows, reduce manual tasks, and ultimately allow the team to focus on what matters most: delivering the best possible care for their patients.

Outside of work, Jonathan leads a busy and active life. He has three children, all currently in university. In his free time, Jonathan enjoys road and trail running along the rugged coastline of Atlantic Canada, as well as cycling and backpacking through the coastal and mountain regions of northeastern North America. During the winter months, you’ll often find him on the curling rink.

This picture was provided by Jonathan, of a backpacking trip with his daughter, Lauren, at Cape Chignecto in Nova Scotia.