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Development and testing of multiple versions of a radiation oncology treatment planning workflow application in the era of HIPAA.

2010; Lippincott Williams & Wilkins; Volume: 28; Issue: 15_suppl Linguagem: Inglês

10.1200/jco.2010.28.15_suppl.6151

1527-7755

John B. Fiveash, J. Howerton, M. Hyatt, K. Sinclair, Omer L. Burnett, Richard A. Popple, Brian L. Graham,

Advances in Oncology and Radiotherapy

6151 Background: To develop and test a clinical workflow application that manages the radiation oncology treatment planning process for multiple physicians and planners in a multi-site academic oncology practice including notifications and user level data collection and reporting for process improvement. This functionality is not integrated into most oncology electronic medical record or treatment planning systems. Methods: Resident and attending physicians, physicists, dosimetrists, RTTs, and administration staff at the University of Alabama at Birmingham Department of Radiation Oncology were interviewed to define the treatment planning workflow process and logic. Prototype applications were developed and tested on several platforms including MS Access hosted on a departmental server, MS Sharepoint web application, and an internally hosted version of Oracle Application Express (APEX) with Oracle 10g. All solutions were assessed for ease of use and for privacy and security liabilities. Results: The userbase defined the treatment planning process from scheduling a patient for simulation through all steps in treatment planning to quality assurance. Either one or two physicians completed testing of each functional prototype over a two-year period with over two hundred patient courses. The MS Access solution was rejected due to FDA requirements that third party software not be installed on treatment planning workstations unless previously approved. The MS Sharepoint website did not meet the institution's requirement for HIPAA disclosure auditing. Therefore, an existing LDAP authentication schema for electronic medical record access was incorporated into the Oracle Apex solution. Conclusions: FDA and HIPPA requirements limited software choice and increased the cost of the project. The web-based Oracle APEX solution meets the department's functional requirements for ease of use and meets the institution's requirements for privacy and security. The application improves communication between physicians and planners at multiple locations through online lists and automated email/pager notifications. No significant financial relationships to disclose.