Our November User of the Month remembers his first encounter with Radformation tools vividly. In December 2018, Ryan Manger watched a LinkedIn demo for EZFluence and was immediately struck by how well it addressed the challenges he and his team faced every day in clinical work. "The design was so intuitive," he recalls, thinking of that first impression. "From the very beginning, it was clear Radformation products were created with our specific clinical challenges in mind."
As the lead physicist at UC San Diego’s Encinitas location—a one-linac clinic treating 40 patients each day—Ryan knew just how critical it was to find tools that could truly optimize the clinic’s workflow but would also work for the greater team of 19 physicists and 24 radiation oncologists throughout the UC San Diego Health System. EZFluence and ClearCheck quickly became a foundational framework in the clinic, empowering the entire team to maintain the highest standards in patient care without compromising on safety or efficiency.
The integration of ClearCheck aligned perfectly with UCSD’s departmental initiative to standardize treatment guidelines for each disease site. Ryan’s team created over 90 constraint templates to ensure consistency in quality and plan specifications. As he explains, "ClearCheck proved to be the ideal solution for ensuring the guidelines were being followed in practice." By defining these standards, his team was able to focus more time on high-value aspects of patient care, fully embodying the goals of MedPhys 3.0. ClearCheck alone drastically simplified the previously cumbersome process of documenting treatment plans by consolidating data across MU verification, IMRT QA, and treatment planning systems into a single report. "Now, everything is integrated in one place," he says, which frees up more time to focus on patient planning and other meaningful clinical work.
The straightforward implementation process has been integral in adopting automation at UCSD. Ryan found that Radformation’s responsive support team made transitions smooth, ensuring each tool met the team’s needs.
Perhaps one of the most transformative tools, however, has been ChartCheck, which completely restructured UCSD’s weekly check workflow. "Our old weekly check process had 20 manual checks and 8 automated checks," Ryan explains. With ChartCheck, they were able to reduce this to "5 manual and 24 automated checks," while also automating documentation. This has saved time for his team and provided vital support for billing audits, allowing them to promptly supply insurers with the required documentation.
Since its implementation, ChartCheck has impressively helped UCSD track over 26,000 fractions across more than 2,000 patients. Ryan points to the automatic monitoring of imaging shifts as one of the most meaningful changes, explaining that previously his team relied on “tolerance tables,” which missed unindexed shifts that might affect treatment. ChartCheck now allows his team to more effectively monitor shifts for each fraction, uncovering adjustments that previously went undetected and enhancing patient setup accuracy. Furthermore, Ryan appreciates the batch approval feature that helps physicists prioritize flagged cases, providing more time to focus on patients needing attention rather than spending energy on routine cases.
The integration of Radformation’s suite has not only streamlined processes but has also reduced errors late in the planning process that might have led to treatment delays, leading to positive impacts. Ryan believes that "reducing these errors improves our patient outcomes," helping patients start their treatment on time and ensuring the highest standards of care.
Ryan wanted to send a special acknowledgment to many of his team members. "I’m fortunate to work with the best dosimetrist in the world, Patricia Hua. She has been indispensable in more ways than I could count. I’d like to thank our Medical Director, Jim Urbanic, and our clinic managers, Jen Murray and Matt Taylor, for trusting me and supporting our use of EZFluence and ClearCheck in the early days. Our departmental leadership - Todd Pawlicki, Grace Kim, and AJ Mundt – have been supportive, allowing us to integrate Radformation’s family of products in our clinical processes. Lastly, I’d like to acknowledge the impactful work of Jeremy Hoisak and Irena Dragojevic working with me to test and fine-tune ClearCheck and ChartCheck."