Automation In Radiotherapy Clinical Workflow Using an Event-Driven Framework
Abstract
Purpose
To improve the effectiveness and efficiency of radiotherapy clinical workflows, we developed and deployed three vendor-specific Event-Driven Framework (EDF) automation applications that reduce manual intervention and enhance communications among therapists, physicians, dosimetrists, and medical physicists.
Methods
First, using EDF, an independent secondary dose verification process was fully automated. Upon physician plan approval in the Treatment Planning System (TPS) EDF triggered the export of DICOM-RT files, automatically executed secondary dose calculations, and uploaded the resulting report to Treatment Management System. Second, due dates for CarePath tasks (Varian, Siemens) were automatically adjusted by EDF based on pre-defined planning timelines, triggered by patient start-date scheduling or CT simulation completion events. Third, an EDF-based event listener was developed to detect physician prescription amendments and automatically send real-time notifications to the planning and radiation therapist teams. These three EDF clinical workflow automations were evaluated using survey responses to assess time savings (efficiency), reliability, patient safety, workflow improvement, and frequency of manual interventions.
Results
In 2025, EDF secondary dose verification automated workflows for 11,538 patients, EDF task auto-adjustment for 9,819 patients (projected based on six-months of deployment), and EDF eRx automated for 812 patients. Survey responses from 40 participants demonstrated substantial time savings, ranged from 5.6 to 11.3 minutes per patient, with EDF eRx achieving the greatest efficiency gain (11.3 minutes per patient), followed by the other two systems (both ~6 minutes per patient). Satisfaction survey results showed strong performance in reliability (86.8%), minimal manual intervention (89.2%), and improved efficiency (81.1%), while patient safety received 73.2% positive responses.
Conclusion
We have demonstrated that EDF-based workflow automations improved efficiency, consistency, and communications among clinical staff with significant flexibility both for time (asynchronous work) and work location (cross-campus or remote). By reducing manual interventions and standardizing key processes, these automations enhanced operational performance and patient safety.