Checklist and quality assurance tools for integration of two radiation oncology information systems (ROISs)

Merging two radiation oncology information systems (ROISs) is often necessary due to system changes or hospital integrations. ROIS integration is a high-risk procedure, that requires clear procedural guidelines and comprehensive QA methods to ensure safe practice.

This paper presents checklists, procedures, and challenges associated with integrating a ROIS into a centralized system, providing procedural guidelines and QA methods. It also shares our experience of merging with one ROIS into another.

The integration process comprised five major components: machine information; under-treatment patients' information (treatment plans, history, images, and electronic medical records [EMR]); user-generated workflows; ROIS user information; and beam-related information, if any (e.g., beam calibration). The procedures were divided into three parts: site survey and preparation-phase activities, QA during integration, and QA after integration. Software tools were developed to compare data before and after the merger. Integration of legacy data was not considered in this process.

We successfully integrated a standalone practice site into a main ROIS, which may serve multiple sites, over the course of a single weekend using the developed tools and checklists. By the following Monday, after 45-person hours of integration work by therapists, dosimetrists and physicists, the newly integrated practice site was able to seamlessly use the centralized ROIS to continue radiation treatment for its patients already under care. The entire procedure was completed without any downtime at any site.

We have developed and successfully tested a structured set of checklists, procedures, and tools for the seamless integration of a practice site into an existing ROIS. This approach provides the radiation oncology community with a framework for achieving safe and efficient practice integration.