Workflow Wins: Navigating Change Using Automation

Introduction
The Department of Radiation Oncology at University Hospital Würzburg is located in northern Bavaria, Germany. With services including online adaptation, IMRT, SRS, SBRT, TBI, and brachytherapy, the department offers a full complement of treatment options to the local community. 

In 2020, the department transitioned from Pinnacle treatment planning system (TPS) to Eclipse. When seeking to replace the automated elements they had in place prior to their TPS change, they found ClearCheck from Radformation.

ClearCheck is an automated plan evaluation and documentation tool that ensures high quality treatment plans through efficient plan checks, dose constraints, and comprehensive documentation.

The physics team at University Hospital Würzburg saw the potential in ClearCheck to be a central platform for multiple different plan evaluation tasks. With automated features designed to facilitate the plan review process, they implemented ClearCheck to make their workflow more efficient and effective.

Automating multiple workflow steps with a single solution
Adopting a new TPS can be both exciting and daunting. For Würzburg, the change meant moving away from previously established workflows that heavily relied on custom scripts for automating various tasks like DVH evaluation and plan reporting.

In a new environment, they aimed to implement solutions that could similarly enhance efficiency within the treatment planning process. While the team developed certain ESAPI scripts internally using their in-house expertise, these did not fully meet their needs for connectivity and comprehensive functionality. Then, they discovered ClearCheck.

“Despite the challenges and increased workload associated with changing TPS (Pinnacle to Eclipse), we gained more automated verification parameters and safety checkpoints, which benefits both physicists and MDs,” says Robert Schindhelm, physicist at University Hospital Würzburg.

With so many different functions available within ClearCheck, they no longer need to rely on in-house scripts or spreadsheets to patch together their treatment planning and documentation process.  Exploiting the software's customizability, the physics team was able to consolidate multiple efforts into the plan evaluation platform.

They now perform DVH constraints evaluations, assess plan parameters, and generate a full patient plan report—all within the same software. Furthermore, they gained the ability to easily compare plans to determine the best fit. And plan sums—for boost plans or previous irradiation alike—have never been easier to analyze. “We’ve found that our plan verification workflow, from preparing for optimization through plan review, could be perfectly automated through ClearCheck,” says Robert.

Efficiency and Time Savings
After implementing the tools that ClearCheck provides, the team noticed immediate improvements in their planning workflow. According to Robert, “Evaluations are automated and standardized, allowing for the verification of important dosimetric values and plan-specific parameters within seconds.”

On the reporting side, they were quickly captivated by the PDF-to-ARIA feature. Creating a very detailed, relevant report that directly populates to the ARIA Documents workspace eliminates the need for manual export/import, freeing up valuable physicist time which can now be assigned to focus on personalized patient care. 

With more information at their fingertips, they’ve incorporated their physician colleagues into the optimization and planning process. Physicians now can quickly verify key dose constraints and plan parameters, leveraging ClearCheck’s visualization tools and streamlined data access. This empowers them to participate more actively in the planning process, leading to more effective teamwork and fewer planning iterations. 

Conclusion
Powered by intelligent automation software, Robert and the physics team at University Hospital Würzburg have successfully navigated the major hurdles associated with a new treatment planning system. With the help of ClearCheck, they’ve unified many tasks on one platform, automating the planning workflow for higher levels of efficiency. 

The implementation has had an unintended, yet highly positive, side effect: improved team communication. From plan notes to therapists to facilitating better conversation with physicians, ClearCheck simplifies communication and fosters collaboration.  According to Robert, “ClearCheck has not only streamlined the planning process but also fostered greater collaboration among team members, enhancing overall efficiency and freeing up time to focus on elevating patient care.”