3734 - Bridging Data and Practice: A Dashboard to Optimize Radiotherapy Prescriptions for Bone Metastases

Purpose/Objective(s): There is wide variation in the use of single fraction radiotherapy (SFRT) for symptomatic bone metastases. Data stored in radiotherapy information systems has potential for use in assessing variance in radiotherapy prescriptions from best practice. This project aimed to develop and implement a digital dashboard, providing clinicians with a visual display of their own radiotherapy prescribing patterns, hypothesizing that this would result in increased use of SFRT for treatment of bony metastases.

Materials/Methods: A departmental consensus guideline of appropriate indications for SFRT was developed, allocating these to a traffic light system, with ‘green’ being ‘suitable for SFRT’, ‘amber’ being ‘likely suitable for SFRT’ and ‘red’ being ‘unsuitable for SFRT’. A digital dashboard was developed by mapping and identifying data regarding palliative radiotherapy prescription and delivery from the radiotherapy information system. Clinicians could login to the dashboard online to view a summary of their own SFRT prescribing rates in comparison to their peers and departmental rates. Data was displayed in graphical format, with the ability to identify patients not receiving SFRT for further investigation. Clinicians received monthly reminder emails to login and review their prescribing practice. Departmental adherence to the consensus guideline was reviewed at bimonthly morbidity and mortality meetings. Impact of the dashboard was assessed by comparison of SFRT prescribing patterns for bone metastases in the 6 months prior to and up to 12 months of dashboard implementation. Clinician opinion on utility and usability of the dashboard was assessed via an anonymous online survey.

Results: SFRT utilization increased from 40% in the 6-months pre-dashboard to 57% in the final quarter 12-months post-dashboard implementation (Table 1). Clinicians generally found the dashboard easy to use, but were unsure whether they would use it without prompting or whether it would change their clinical practice. Several clinicians noted that the dashboard data display would benefit from more nuanced details, including data on treatment rationale, but this type of information could not be automated.

Conclusion: Implementation of a clinical dashboard to monitor prescribing patterns for bony metastases led to an increased use of SFRT, suggesting that it may be an effective tool to improve adherence to best practice in radiation prescribing. However, the observed changes may also have been influenced by regular discussions at departmental meetings. Clinician feedback on dashboard utility and usability was mixed.

Abstract 3734 - Table 1