Re: Paperless Radiation Oncology

[Scott Dube]

Hello Aria users.  Jeff seeks wisdom regarding the conversion to electronic charting with Aria.  As a previous MOSAIQ user, I will say Aria does not provide a robust way to change the prescription mid course and ensure the change is implemented.  How do you do it?

On Tue, Jul 21, 2015 at 1:05 PM, Jeff Garrett <JGar...@mbhs.org> wrote:

Hi Folks,

Looking for a good paper or two or three that illuminates the processes
needed in order to move to a paperless radiation oncology department. Or
if you'd like to provide your own thoughts on the mat

​t​

er I'd certainly like
to hear those as well. Specifically, I'm interested in how a site deals
with changes to the prescription mid treatment and the best methods to
ensure modifications are caught and verified without a piece of paper
telling you to make those changes. Thanks in advance.

Jeffrey A. Garrett, MS, DABR
Chief Physicist
Mississippi Baptist Medical Center
1225 North State Street
Jackson, MS 39202

[Kyle Caldwell]

Assuming you are using Eclipse and ARIA, you would simply create a plan revision in Eclipse.  This will retire the initial plan (will not be able to treat it at the machine), and allow you to edit the prescription or change the plan as prescribed by the physician.  After reviewing the new plan, the physician would "planning approve" the new prescription/plan.  The dosimetrist would finalize the plan for treatment and prepare a .pdf plan report to add to the EMR as with any plan.  The physicist would "treatment approve" the new plan after a physics check, allowing treatment to resume with the new plan.  You can customize a plan modification care path to notify any staff desired without paper as well.

KC

[Scott Hadley]

Hi,

There is a task group now working on capturing the current practice for electronic charting.

For the Aria prescription question here's our work around.Keep in mind Aria has no way to revise or complete early a script.

Option 1 is to revise the plan in Eclipse. If I remember correctly this will keep the revised plan attached to the script. It will be obvious to all users that the revised plan supplanted the predisessor plan.

Option 2 that we use is to make a new script to finish out the old one. So if the old one was for 25fx and we are quitting at 9 we make a new script for 9 and have the MD approve it. Then a new script is made for the plan that comes next. It's the best way we found to know that the MD wanted to stop at 9 and not go to the full 25.

Option 3 that we don't use is to have the MD "complete early" the plan. Then if you want a new plan they need to sign a new script. If policy is written so that a completed early plan means the script is also completed early then it should be easy for everyone to know.

I'd love to hear some better ways to do it.

Scott

[Jeff Garrett]

We are implementing the following solution when there is a need to change the dose/fx or # fractions.

1. We created an encounter that contains a Task to Dosimetry that there is a change in dose. This is nice in that is shows up when the Therapists add their Daily Time Out and informs them that there has been a change in the prescription. In the encounter there is also a Review Prescriptions item. This has a link to the Prescriptions workspace so the docs just have to click this and it'll take them directly to that workspace to edit their Rx's.

2. All Prescriptions will be approved AND linked to a plan. Once the Rx is edited the plan can no longer be treated as it will take away treat Approve and only Physics can treat approve.

Jeff