What You Need to Know to Prepare for an Oncology Information System & Treatment Planning System Upgrade: A Risk-Based, Multidisciplinary Workflow
Abstract
Purpose
Oncology information system (OIS) and Treatment planning system (TPS) upgrades are high-impact events that require comprehensive validation. Knowing what to prepare, who to involve, and what to test on go-live day is critical for patient safety and clinical continuity. Guided by the risk-based principles of AAPM TG-100 and the verification recommendations of MPPG 5a, this work shares a practical, preparation-focused workflow developed for a recent ARIA V15 to V18 OIS-TPS upgrade.
Methods
Preparation began months before the actual upgrade and focused on building clinical readiness rather than reacting on the day of the upgrade. A prospective risk assessment was used to identify treatment sites, techniques, and workflows that are most sensitive to algorithm and beam-model changes. Early and active engagement with the vendor (Varian), institutional IT, departmental administration, radiation therapists (RTTs), dosimetrists, and physics staff ensured clear expectations, protected downtime, and defined escalation pathways. Physics-led preparation included verification of the beam model, definition of acceptance criteria, and advanced selection of representative clinical plans to test known risk areas. Day-of-upgrade testing followed a structured, checklist-driven process aligned with MPPG 5.a recommendations. Testing emphasized system integrity, dose-calculation consistency, and end-to-end clinical workflow validation, including CT simulation, plan creation, physician/physics approval, data transfer, treatment-delivery & data recording, and ancillary system integration.
Results
All predefined tests were completed within the planned downtime, with no high-risk failure modes identified. For one linac software re-installation was needed since it was discovered that the dose and images were not saved back to the OIS. End-to-end testing confirmed readiness to safely resume patient treatments on schedule.
Conclusion
Successful OIS/TPS upgrades are won in the preparation phase. A proactive, risk-informed, and multidisciplinary workflow transforms the upgrade from a disruptive event into a controlled clinical transition, improving safety, efficiency, and team confidence.