Challenge
Maastro proton therapy center for cancer patients in Maastricht, Netherlands expects to be able to treat around 400 patients from the southeast Netherlands each year. The Maastro proton therapy center is the first proton facility in the world that is being integrated into an existing building. Proton therapy is a new, advanced form of radiation (radiotherapy) and treats tumors with a higher precision of radiation than is applied in traditional photon radiotherapy. Patients in the past were receiving the best possible photon therapy or were forced to go abroad for proton therapy.
Aim
Using the Vitaly solution for Multidisciplinary Team Meetings, Maastro will be enabled to receive referrals from other hospitals in the Netherlands and the broader region. At the beginning of the project, there will be 5 referral hospitals, and the network will grow exponentially in the future by adding more hospitals – even the ones from abroad.
Solution
In April 2019, the Multidisciplinary Team Meetings solution for Maastro was successfully implemented, enabling care professionals to receive and manage proton therapy referrals from other connected hospital entities. The initial goals of connecting 5 referral hospitals were achieved, and it is expected to enhance collaboration among other distant hospitals and expand their innovative offering of proton therapy further on.
The solution is enabling Maastro to receive referrals according to IHE standards in an interoperable way (XBeR-WD). The Referral Management Portal is integrated with VNA in order to exchange documents and DICOM images and in addition, also with HIS (e.g. HIX) to exchange patient identities and demographic data.
The main advantage is that DICOM studies can be uploaded directly to the application, meaning that the referral service is also available to the hospitals, which do not exchange any clinical information with Maastro through the HIE infrastructure yet and empower the professionals involved with up-to-date patient case information for greater decision-making.
Screen 1: Login page
The first part is plan comparison (assessment) when a referral doctor (this could be done even by a secretary on behalf of the referring doctor) submits a request through Vitaly with all the documentation needed to refer a patient case. They need to fill out the form and upload the documents requested (other medical documentation and a consent). The main advantage is that all DICOM studies can be uploaded directly to the application itself which means that there is no additional integration between all the referring hospitals needed. The team in Maastro then reviews the case and returns a calculation and a treatment plan within 24 hours. They also have a dedicated team that is responsible for reviewing and deciding about each case; they can also reject the case if there is a lack of documentation or if the documentation provided could not be readable.
Screen 2: Dashboard of Requesting Doctor
Screen 3: Request form
When the referral doctor receives a response from Maastro, the next step is an actual referral to Maastro. The referral doctor, after a discussion with a patient, can decide whether he is going to refer a patient to Maastro or not.
Screen 4: Finalisation process
The user-friendly process enables a referring doctor to reply to his decision. If he is going to refer a patient to Maastro, then he is redirected to the last step of the process where he needs to fill out another form and provide some additional information required. Maastro immediately proceeds with the treatment as soon as they receive an actual referral from a referral doctor.
The Referral Management Portal is integrated with VNA in order to exchange documents and DICOM images and in addition also with HIS (e.g. HIX) in order to exchange patient identities and demographic data.
Standards
The whole process is designed as a web-based application in a way that is user-friendly for the end-user with the end goal of making every step of the process efficient considering standards within the Healthcare IT domain. The solution is using the following IHE profiles: