TY - JOUR
T1 - Implementation of a Novel Remote Physician Stereotactic Body Radiation Therapy Coverage Process during the Coronavirus Pandemic
AU - Price, Alex
AU - Henke, Lauren E.
AU - Maraghechi, Borna
AU - Kim, Taeho
AU - Spraker, Matthew B.
AU - Hugo, Geoffrey D.
AU - Robinson, Clifford G.
AU - Knutson, Nels C.
N1 - Funding Information:
Disclosures: Mr Price reports personal fees from Sun Nuclear Corporation, personal fees from ViewRay, Inc, outside the submitted work. Dr Henke reports personal fees from ViewRay Inc, grants and other from Varian Medical Systems, outside the submitted work. Dr Maraghechi has nothing to disclose. Dr Kim has nothing to disclose. Dr Spraker reports grants from Varian Medical Systems, Inc, grants from American College of Radiology, and grants from Emerson Collective, outside the submitted work. Dr Hugo reports grants and personal fees from Varian Medical Systems, grants from Siemens, and grants from ViewRay, outside the submitted work. Dr Robinson reports grants and personal fees from Varian, grants from Elekta, and other from Radialogica, outside the submitted work. Dr Knutson has nothing to disclose.
Publisher Copyright:
© 2020 The Author(s)
PY - 2020/7/1
Y1 - 2020/7/1
N2 - Purpose: During the coronavirus 2019 disease (COVID-19) pandemic, alternative methods of care are needed to reduce the relative risk of transmission in departments. Also needed is the ability to provide vital radiation oncological care if radiation oncologists (RO) are reallocated to other departments. We implemented a novel remote RO stereotactic body radiation therapy (SBRT) coverage practice, requiring it to be reliable, of high audio and visual quality, timely, and the same level of specialty care as our current in-person treatment coverage practice. Methods and Materials: All observed failure modes were recorded during implementation over the first 15 sequential fractions. The time from cone beam computed tomography to treatment was calculated before and after implementation to determine timeliness of remote coverage. Image quality metrics were calculated between the imaging console screen and the RO's shared screen. Comfort levels with audio and visual communication as well as overall comfort in comparison to in-person RO coverage was evaluated using Likert scale surveys after treatment. Results: Remote RO SBRT coverage was successfully implemented in 14 of 15 fractions with 3 observed process failures that were all corrected before treatment. Average times of pretreatment coverage before and after implementation were 8.74 and 8.51 minutes, respectively. The cross correlation between the imaging console screen and RO's shared screen was r = 0.96 and lag was 0.05 seconds. The average value for all survey questions was more than 4.5, approaching in-person RO coverage comfort levels. Conclusion: Our novel method of remote RO SBRT coverage permits reduced personnel and patient interactions surrounding radiation therapy procedures. This may help to reduce transmission of COVID-19 in our department and provides a means for SBRT coverage if ROs are reallocated to other areas of the hospital for COVID-19 support.
AB - Purpose: During the coronavirus 2019 disease (COVID-19) pandemic, alternative methods of care are needed to reduce the relative risk of transmission in departments. Also needed is the ability to provide vital radiation oncological care if radiation oncologists (RO) are reallocated to other departments. We implemented a novel remote RO stereotactic body radiation therapy (SBRT) coverage practice, requiring it to be reliable, of high audio and visual quality, timely, and the same level of specialty care as our current in-person treatment coverage practice. Methods and Materials: All observed failure modes were recorded during implementation over the first 15 sequential fractions. The time from cone beam computed tomography to treatment was calculated before and after implementation to determine timeliness of remote coverage. Image quality metrics were calculated between the imaging console screen and the RO's shared screen. Comfort levels with audio and visual communication as well as overall comfort in comparison to in-person RO coverage was evaluated using Likert scale surveys after treatment. Results: Remote RO SBRT coverage was successfully implemented in 14 of 15 fractions with 3 observed process failures that were all corrected before treatment. Average times of pretreatment coverage before and after implementation were 8.74 and 8.51 minutes, respectively. The cross correlation between the imaging console screen and RO's shared screen was r = 0.96 and lag was 0.05 seconds. The average value for all survey questions was more than 4.5, approaching in-person RO coverage comfort levels. Conclusion: Our novel method of remote RO SBRT coverage permits reduced personnel and patient interactions surrounding radiation therapy procedures. This may help to reduce transmission of COVID-19 in our department and provides a means for SBRT coverage if ROs are reallocated to other areas of the hospital for COVID-19 support.
UR - http://www.scopus.com/inward/record.url?scp=85086050799&partnerID=8YFLogxK
U2 - 10.1016/j.adro.2020.04.012
DO - 10.1016/j.adro.2020.04.012
M3 - Article
C2 - 32346656
AN - SCOPUS:85086050799
SN - 2452-1094
VL - 5
SP - 690
EP - 696
JO - Advances in Radiation Oncology
JF - Advances in Radiation Oncology
IS - 4
ER -