R. Ma1, S. Ganguly1, C. Polvorosa1, J. Baker2, J. Chang3, and Y. Cao3; 1Northwell, New Hyde Park, NY, 2Northwell, Lake Success, NY, 3Northwell Health, New Hyde Park, NY
Purpose/Objective(s):The Directive Application is designed to revolutionize the management of Radiation Treatment Directives crucial for over 170 cancer treatment pathways in Radiation Oncology. This initiative addresses the significant challenges posed by the current reliance on plain text documents and the limitations of MS Word formats by transitioning to a centralized relational database. The project aims to ensure data integrity, efficiency, and safety in clinical information management, thereby improving clinical workflows, document integrity, patient safety, and reducing human resource expenses across multiple oncology clinic sites. Materials/
Methods: The development process involved converting directives into a structured digital format, focusing initially on Head & Neck and Breast cancer treatments, using an open-source relational database for its robustness and minimal redundancy. The schema was carefully designed and relations between tables were thoroughlyconsidered to ensure long-term stability and maximal flexibilityof the database. As commonly used in clinical trials, standard nomenclature consistent with AAPM TG-263 guidelines were utilized whenever possible. A user-friendly application framework was created, featuring direct data transfer interfaces with healthcare systems, comprehensive Directive management tools, and the ability to generate usage reports. This setup supports a wide array of data formats and introduces automated version control to enhance document accuracy and integrity. Results: The Directive Application has demonstrated its capacity to overcome workflow inefficiencies, digitizing directives for test sites and showcasing improvements in clinical operations. The centralized data management system reduces manual document handling and shortens update cycles for clinical directives, ensuring updates are universally reflected. Preliminary feedback underscores a decrease in directive discrepancies, enhanced data accuracy, streamlined communication, and potential for clinical workload management improvements. These findings indicate significant strides towards optimizing workflow and patient care quality. Conclusion: The Directive Application marks a pivotal advancement in Radiation Oncology, simplifying the management of Radiation Treatment Directives and centralizing clinical information within a relational database. While internal demonstrations and initial feedback suggest improvements in workflow efficiency, document integrity, and information accuracy, the full impact on patient care quality and safety requires broader implementation and further evaluation. This cautious optimism underlines the applications potential to contribute significantly to cancer treatment advancements, emphasizing the need for rigorous testing and validation in its continued development.
