Multimodal Document Management in Radiotherapy, an Update

  • Harald Fahrner Department of Radiation Oncology Medical Center - University of Freiburg
  • Stefan Kirrmann Department of Radiation Oncology Medical Center - University of Freiburg
  • Mark Gainey Department of Radiation Oncology Medical Center - University of Freiburg
  • Marianne Schmucker Department of Radiation Oncology Medical Center - University of Freiburg
  • Martin Vogel Head of Development and Engineering Max Planck Institute of Biophysics Frankfurt
  • Felix Ernst Heinemann Department of Radiation Oncology Medical Center - University of Freiburg http://orcid.org/0000-0002-7282-8689

Abstract

Background: In 2013, we presented a study entitled “Multimodal document management in radiotherapy”, demonstrating the excellent routine performance of the system about four years after its initiation by evaluating a sample of n=500 documents. During this time the system saw additional developments and significant improvements: the most important innovative step being the automatic document processing. This has been completely reworked, to minimize staff-machine interaction, to increase processing speed and to further simplify the overall document handling. This improved system has been running practically without any problems for several months. Methods: While reworking the automatic document processing, we have developed algorithms that allow us to transfer documents with varying type, within a single scanning procedure, into our departmental system. The system identifies and corrects for any arbitrary order or rotation of scanned pages. Finally, after the transfer into the departmental system, all documents are in the correct order and they are automatically linked to the respective patient record.  Results: According to our surveys, the error rate of the system, as in the previous version, is 0%. Compared to manual scanning and mapping of documents, we can quantify a 30-fold increase in the processing speed. In spite of these additional and elaborate processes, code optimizations yielded a processing speed increase of 20%. Pre-sorting of the documents (e.g., medical reports, or documents of informed consents) can be completely dispensed with the automated correction for jumbled documents or document rotations. In this manner 25,000 documents are automatically processed each year in the Department of Radiation Oncology at the University of Freiburg. Conclusion: With the methods presented in this study, and some additional bug fixes, and small improvements, automatic document processing of our departmental system was significantly improved without compromising the error rate.

Keywords: Clinic management, documents, workflow, optimisation, efficiency, automation, Mosaiq, oncology informatics

 

Author Biographies

Harald Fahrner, Department of Radiation Oncology Medical Center - University of Freiburg
Harald Fahrner, IT Specialist, employee of Clinical and Administrative Information Technology Department

Department of Radiation Oncology

Medical Center - University of Freiburg

Stefan Kirrmann, Department of Radiation Oncology Medical Center - University of Freiburg
Stefan Kirrmann, IT Specialist, employee of Clinical and Administrative Information Technology Department

Department of Radiation Oncology

Medical Center - University of Freiburg

Mark Gainey, Department of Radiation Oncology Medical Center - University of Freiburg
Mark Gainey, physicist PhD, employee of Department of Medical Physics

Department of Radiation Oncology

Medical Center - University of Freiburg

Marianne Schmucker, Department of Radiation Oncology Medical Center - University of Freiburg
Marianne Schmucker, medical doctor MD, managing senior physician

Department of Radiation Oncology

Medical Center - University of Freiburg

Martin Vogel, Head of Development and Engineering Max Planck Institute of Biophysics Frankfurt
Martin, phsicist PhD, Head of Development and Engineering
Max Planck Institute of Biophysics Frankfurt
Felix Ernst Heinemann, Department of Radiation Oncology Medical Center - University of Freiburg
Felix Heineman, medical computer scientist, medical doctor MD, Head of Clinical and Administrative Information Technology Department

Department of Radiation Oncology

Medical Center - University of Freiburg

References

1. Heinemann F, Röhner F, Schmucker M, Bruggmoser G, Henne K, Grosu A-L, et al. Abteilungs- und Patientenmanagement in der Strahlenheilkunde. Strahlenther Onkol. 2009;185(3):143-54.

2. Röhner F, Schmucker M, Henne K, Momm F, Bruggmoser G, Grosu AL, et al. Integration der Bestrahlungsplanung in den volldigitalen Workflow. Strahlentherapie und Onkologie. 2013;189(2):111-6. doi: 10.1007/s00066-012-0259-0.

3. Torresin A, Carbonini C, Ferrari M, Asnaghi D, Botturi M. Planning and verification in radiotherapy: our experience in a filmless hospital. Polish Journal of Medical Physics And Engineering. 2009;15(2):103-12. doi: 10.2478/v10013-009-0010-z.

4. Fahrner H, Kirrmann S, Rohner F, Schmucker M, Hall M, Heinemann F. [Multimodal document management in radiotherapy]. Strahlenther Onkol. 2013;189(12):1032-9. doi: 10.1007/s00066-013-0451-x. PubMed PMID: 24196281.

5. DEGRO. Positionspapier Elektronische Krankenakte in der Strahlentherapie2010.

6. Yu WX, Zhang H, Luo LM. [DICOM in radiotherapy]. Zhongguo yi liao qi xie za zhi = Chinese journal of medical instrumentation. 2002;26(5):352-5. PubMed PMID: 16104266.

7. Neumann M. DICOM--current status and future developments for radiotherapy. Zeitschrift fur medizinische Physik. 2002;12(3):171-6. PubMed PMID: 12375450.

8. Law MYY, Liu B. Informatics in Radiology DICOM-RT and Its Utilization in Radiation Therapy. Radiographics. 2009;29(3):655-67. doi: 10.1148/rg.293075172. PubMed PMID: WOS:000266790800002.

9. Law MYY, Liu B, Chan LW. DICOM-RT-based Electronic Patient Record Information System for Radiation Therapy. Radiographics. 2009;29(4):961-U3. doi: 10.1148/rg.294085073. PubMed PMID: WOS:000268325800002.

10. Steil V, Schneider F, Küpper B, Weisser G, Wenz F, Lohr F. Patientenbezogenes Bild- und Datenmanagement in der Radioonkologie. Strahlenther Onkol. 2009;185(1):1-7.

11. Texas Dental Association Financial Services L. Data archiving and backup: what you need to know. Texas dental journal. 2007;124(6):612-3. PubMed PMID: 17711053.

12. Behlen FM, Sayre RE, Weldy JB, Michael JS. "Permanent" records: experience with data migration in radiology information system and picture archiving and communication system replacement. J Digit Imaging. 2000;13(2 Suppl 1):171-4. PubMed PMID: 10847391; PubMed Central PMCID: PMC3453274.

13. Avrin DE, Andriole KP, Yin L, Gould R, Arenson RL. Simulation of disaster recovery of a picture archiving and communications system using off-site hierarchal storage management. J Digit Imaging. 2000;13(2 Suppl 1):168-70. PubMed PMID: 10847390; PubMed Central PMCID: PMC3453250.

14. Camacho Rodriguez JC, Staubert S, Lobe M. Automated Import of Clinical Data from HL7 Messages into OpenClinica and tranSMART Using Mirth Connect. Stud Health Technol Inform. 2016;228:317-21. PubMed PMID: 27577395.

15. Dunn R. A quick scan of bar coding. When planning document imaging systems, don't forget the bar codes. J AHIMA. 2006;77(1):50-2, 4. PubMed PMID: 16475736.

16. Flaig M, Graeber S, Sybrecht GW, Innere MV. Use of HL7 to integrate a HIS-subsystem: limits and possibilities 2973. MEDINFO 2001. 2001;Proceedings of the 10th World Congress on Medical Informatics. IOS Press. Part vol.1, 2001, pp. 730-4. Amsterdam, Netherlands. PubMed PMID: 2977.

17. Kolovou L, Darras A, Lymbperopulos D, Patras Univ G. HL7 message handling for intra-hospital information systems 2972. CIMED2005.Proceedings of the 2nd International Conference on Computational Intelligence in Medicine and Healthcare. IEE. 2005, pp. 446-53. London, UK. PubMed PMID: 2976.

18. Koncar M. HL7 standard--features, principles, and methodology 9. Acta MedCroatica. 2005;59(3):273-6. PubMed PMID: 2979.

19. Lohr F, Baus W, Vorwerk H, Schlömp B, André L, Georg D, et al. Rechtliche Grundlagen für den Umgang mit sicherheitsrelevanten Ereignissen in der Strahlentherapie. Strahlentherapie und Onkologie. 2012;188(7):545-50. doi: 10.1007/s00066-012-0119-y.

20. Bundesministerium für Umwelt NuR Richtlinie zur Verordnung über den Schutz vor Schäden durch ionisierende Strahlen (Strahlenschutzverordnung - StrlSchV)2017.

21. Swerdloff SJ. Data Handling in Radiation Therapy in the Age of Image-Guided Radiation Therapy. Seminars in Radiation Oncology. 2007;17(4):287-92. doi: 10.1016/j.semradonc.2007.08.002.

22. Sietmann R. Gerichtsfest archivieren. C‘T Magazin für Computertechnik. 2008;2:46-7.
Published
11-02-2019
How to Cite
Fahrner, H., Kirrmann, S., Gainey, M., Schmucker, M., Vogel, M., & Heinemann, F. (2019). Multimodal Document Management in Radiotherapy, an Update. Journal of Radiation Oncology Informatics, 10(1), 9. https://doi.org/10.5166/jroi-10-1-1
Section
Technical Reports / Case Reports