UC Davis

ABSTRACT Background Radiation treatment planning is a core function within the Radiation Oncology practice utilizing integrated software to develop executable radiation treatment plans to target a tumor and spare surrounding tissues and organs at risk (OAR). In 2018 the University of California, Davis, Health (UCDH) Radiation Oncology department embarked on an effort to replace a legacy treatment planning system with a state of the art, integrated treatment planning system (TPS). RayStation® by RaySearch Laboratories was known to have a longstanding history of innovation within the industry, enhanced clinical features, and cross-platform planning capabilities. In 2019 an interdisciplinary team comprised of radiation oncology (RO) and information technology (IT) representatives convened to conduct extensive evaluation of the RayStation® system security, data flow, infrastructure requirements, and interoperability and subsequently approved this system for purchase in 2019, at which time a project team convened to build the infrastructure including updated computing hardware, enhanced network capabilities, and increased interoperability with the departmental clinical system and devices. The system was turned over to the radiation oncology team for use in 2020. Objectives The objective of this study was to describe the framework for selection and implementation of an integrated treatment planning software within an academic RO department, and to subsequently assess users’ feedback regarding the implementation process, the clinical tools, system availability and support, and to document any lessons learned applicable to similar implementation efforts in the future. Methods A combination of literature review, stakeholder interviews, and direct observation were used to examine and describe the details of project initiation, planning, execution, and transition to support including the clinical feature requirements and cybersecurity considerations. Qualitative interviews were conducted Nov-Dec 2022 to assess user experience with the implementation, training, system performance, and support. Interviews were conducted using Microsoft Teams to record and transcribe the interviews. Interview transcripts were uploaded to Dedooce statistical analysis software and encoded to identify core themes in the user response. Encoded transcript excerpts were exported to Microsoft Excel and analyzed using pivot tables. Results The results of the user experience assessment indicate a high level of satisfaction with the RayStation® system overall. The users expressed positive opinions regarding the look and feel, system layout, system performance, and available clinical tools. There were mixed results regarding the experience with training, and some indication that additional training may be helpful to increase efficiency. Additionally, there were several participants who felt that the clinic would benefit from an overarching strategy to evaluate system features and future upgrades and to develop best practices across the department. There are known issues with the systems interconnectivity, which warrant further assessment and mitigation. These issues are specific to file type compatibility, interface protocols, and firewall rule complexity between interconnected departmental systems.