Error Prevention Via Improved Integration of the Bravos HDR and the Aria Oncology Information System
Abstract
Purpose
HDR brachytherapy procedures are usually time constrained with planning and safety checks performed immediately preceding delivery, often intraoperatively. Additionally, planning systems can be integrated with oncology information systems (OIS) or standalone systems, with plan-checking and treatment preparation processes dependent on specific systems and clinical workflows. The combination of variability in workflow and resources used, and the time constraints may result in mistreatment. Further, integration of HDR afterloader and OISs, if used, if often incomplete. We describe custom hardware/software interlock system that prevents HDR treatment standardized requirement are met.
Methods
A customer-supplied dual relay was connected to the interlock key switch (IKS, designed for afterloaders sharing a vault with other machines) to assert an IKS interlock preventing treatment. The relay is controlled by a Raspberry Pi 4 running a node webserver that passes open/closed signals to the relay based on software generated messages. Software checks that are not part of the vendor HDR-OIS integration include 1. critical checks such as compliance of plans to prescriptions: Dose/Fx, number of Fx, existence of only one ‘approved’ plan, and 2. advisory checks that comprise of various document approvals.
Results
The developed interlock system was successfully established in multiple treatment vaults. The application automatically performs multiple safety checks for the modded-up patient prior to treatment delivery, enable/disables treatment if checks pass/fail, triggers the interlock upon completion of patient treatment, and exports a treatment QA report to the OIS. Software bypass can be set for QA and service tasks.
Conclusion
A custom hardware interlock for HDR treatment was developed to implement critical safety checks. The software is customizable and the hardware is vendor agnostic and can be connected in series to various vendor hardware interlocks.