Purpose

We introduce a system devoted to automatically produce structured data in radiotherapy to: (i) relate clinical outcomes with any variable; and (ii) optimize resources and procedures.

Methods and material

We have designed a detailed workflow for a patient to follow during radiotherapy treatments. Four elements of Oncology Information Systems (OISs) can be mainly interrelated in our system: (a) task lists to be accomplished by the staff; (b) forms to fill in at each step of the workflow; (c) generation of reports; and (d) a system to trigger new tasks, forms or reports when an needed, either automatically or manually. We handle the data dumped into reports with Visual Basic for Word code to store structured data for patients in electronic medical records (EMRs). These EMRs can be further analyzed, generating clinical real-world data in real time, i.e., at any step of the process.

Results

Our system was implemented about the beginning of 2019, producing a database filled with a pool of 1,184 patients in a year. Although one year is not long enough to produce statistically clinical outcomes, we show our results for cancer by anatomical location so far to meet the first goal stated above. With respect to the second goal, we here (1) show the distribution of times taken for the whole radiotherapy process divided by anatomical locations for, (2) study the fractionations schemes used throughout 2019, and (3) evaluate the number of missed sessions of treatment in our institution. Our system also leads to better communication among staff members, dramatically reducing misunderstandings because of the centralization of the information.

Conclusions

We present an integrated customization of an OIS, yet adaptable to others, that makes possible an optimized performance of the department by driving an automatized paperless workflow; and allows for an automatized and effortless collection of structured data throughout the radiotherapy process.

中文翻译：

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有机生成的实时实时数据可用于放射肿瘤学的临床证据

目的

我们引入专门用于自动生成放射治疗中结构化数据的系统，以：（i）将临床结果与任何变量相关联；（ii）优化资源和程序。

方法和材料

我们为患者设计了详细的工作流程，供患者在放射治疗期间遵循。肿瘤信息系统（OIS）的四个要素在我们的系统中主要可以相互关联：（a）由员工完成的任务清单；（b）在工作流程的每个步骤中填写的表格；（c）生成报告；（d）一种在需要时自动或手动触发新任务，表格或报告的系统。我们使用Visual Basic for Word代码处理转储到报表中的数据，以将患者的结构化数据存储在电子病历（EMR）中。可以进一步分析这些EMR，从而实时（即，在该过程的任何步骤）生成临床实际数据。

结果

我们的系统大约在2019年初开始实施，产生了一个数据库，每年有1184名患者。尽管一年的时间不足以产生统计学上的临床结果，但到目前为止，我们仍按解剖位置显示了达到上述第一个目标的癌症结果。关于第二个目标，我们在这里（1）显示整个放射治疗过程所花费的时间分布除以解剖位置，（2）研究整个2019年使用的分割方案，以及（3）评估错过的会议次数我们机构的待遇 我们的系统还可以改善工作人员之间的沟通，大大减少由于信息集中而引起的误解。

结论

我们提出了OIS的集成定制，但可以适应其他定制，通过驱动自动化的无纸化工作流程，使部门的绩效得以优化；并允许在整个放射治疗过程中自动且轻松地收集结构化数据。