The Development and Implementation of Radiation Oncology IQ Script Enabled Plans at the Odette Cancer Centre

Radiation oncology Care Plans are predefined procedures that outline a patient's radiation therapy (RT) path of care. Care Plans allow for standardization of centre-specific procedures and workflows, thereby laying the foundation for autoforwarding of RT tasks and mandatory information capture via assessment forms. However, the integration of Care Plans at a large centre with established workflows is challenging and requires a redesign of numerous processes across all disciplines and site groups in an electronic data management system. Here, we describe the development and implementation experience of IQ Script enabled MOSAIQ Care Plans at the Odette Cancer Centre between summer 2014 and summer 2016.

A core Care Plan development group was formed that included membership from key stakeholders in RT, oncology, and physics. Care Plan pre-development planning was performed in three phases that included (1) collection and organization of all site and technique-specific protocols and procedures, (2) creation of workflow process maps and intimate discussions with potential stakeholders regarding automation and information capture, and (3) integration of design concepts into the IQ Script enabled Care Plans authoring framework. Following pre-planning, IQ Script enabled Care Plans authoring was performed on a test server with standardized naming conventions and tracking sheets for all IQ scripting triggers and events. Care Plan workflows were tested, and a senior therapist transferred individual Care Plans to the production server. Care Plans were then released gradually over a 1-year period, starting with pilot sites with the highest site group member buy-in. A post-implementation survey was performed to assess end-user feedback.

IQ Script enabled Care Plans resulted in standardization of clinical processes including patient booking, autoforwarding of RT tasks, and mandatory information capture. Survey results indicated stakeholder satisfaction with the implementation process. Comments for improving Care Plans included changes to computed tomography simulation assessment forms for more robust capture of dose prescription and fractionation. Overall, the transition to Care Plans allowed our center to enhance information documentation, streamline our RT workflow, and ultimately improve the accuracy and efficiency of patient care. For the radiation oncologist, the use of Care Plans has also eliminated the use of another software system in which to request planning.