2532 - Standardizing Automated Dose-Constraint Evaluation to Enhance Treatment Planning Quality across a Multi-Site Radiation Oncology Network

Purpose/Objective(s):

Accurate and efficient dose-constraint evaluation is essential for safe, high-quality radiation therapy. Our multi-site radiation oncology network historically used locally developed scripts to support plan evaluation; however, these custom tools required intensive manual maintenance, lacked scalability, and were incompatible with upcoming treatment-planning system changes. These limitations increased workflow variability, human error potential, and operational delays.

To replace custom scripting with a standardized, automated dose-constraint evaluation process capable of supporting a large and diverse clinical environment.

Materials/Methods:

Implementation included development of harmonized clinical constraint sets; parallel validation against the legacy workflow; creating of governance processes for standardized updates; and structure, role-specific training for physicians, physicists, and dosimetrists. The new automated process was integrated into routine chart-review workflows, along with a soft forcing-function that embedded the tool into the clinical pathway to encourage consistent use.

Results:

The new workflow has been successfully deployed across the network through a phased, utilization-driven implementation strategy. Adoption began at a single clinic, followed by expansion to one additional clinic per month over four months, then two clinics in the subsequent month, and three clinics in the next, for a total of nine clinics over six months. Although the initial project scope did not include four different affiliate locations, these sites were ultimately onboarded as well due to strong clinical demand.

When deployment reached the main clinic, implementation proceeded by adding four disease sites per month for two months. Multiple sessions were held for physicians throughout each implementation month, while physicists and dosimetrists participated in targeted sessions to understand workflow details and support clinical users. Embedding the tool into the clinical workflow increased adoption and reduced reliance on legacy manual processes.

Users reported improved reliability of constraint assessment, reduced manual intervention, and more consistent application of clinical criteria. The transition also eliminated the significant maintenance burden associated with custom code.

A workforce-efficiency analysis demonstrates an estimated salary offset of approximately $289,000 annually, based on avoided time spent on script maintenance, troubleshooting, and manual constraint checking.

Conclusion:

Replacing custom coding with a standardized, automated dose-constraint evaluation workflow improved accuracy, consistency, and scalability across a multi-site radiation oncology network, while delivering significant operational and financial benefit.