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Screen snaps

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PLanUNC 6.8.x

All windows but pop-ups
In the shaded surface view, the user has chosen a setting of 200 HU so the bone (or table, in posterior view when table is not clipped from the image) is shown as the iso-surface.  Note the amount of space used to display images (vs. buttons or text) is quite large, and that this user has chosen to waste some screen space and also not to display some of the 10 windows.

Goal Sheet, page 1   Goal sheet, page 2
The goal sheet summarizes the status of all dose values limits in a single view (well, it's 2 pages so it's actually 2 views, to be technically correct). Some constraints are not actual dose but are statistics on dose (like a mean dose).  The constraints are color-coded  red  (failed constraint) or  green  (passed constraint) to indicate if each constraint has been met. The sheet is specific to a planning protocol (example: head & neck IMRT with parotid sparing) and each goal is specified by a doctor in a design stage (not per patient) from that doctor's experience.   UNC has decided that the clinic, as a whole, must agree on a set of goal sheets, specifically, a doctor cannot define his own sheets that are used only for his patients, and so the sheet is hard to change (requires a programmer).  One could imagine other clinics may wish to design sheets with other collaborations in mind, which might require that a clinician with proper permissions be able to change the constraints.   The sheet is always presented as a final check when the plan is approved for treatment, but can be viewed during the planning process as well; red boxes are acceptable for treatment but the doctor needs to justify this decision with a written note.

tPLUNC (simplified teaching version) 6.9.x

all windows but pop-ups 
This DVH variant displays all anastructs across all selected plans on a single graph with convenient but redundant controls for selecting anastructs and plans. Although it tends to get cluttered (esp for head & neck cases with many anastructs), it takes less screen room.  The dose window above displays color washes to visually distinguish them from other sharp-lined edges like isodose lines and beam edges.  The UNIT windows show the linac in this beam's treatment position (from room top and from couch foot), and shows the mock-up of the patient's surface used to detect collisions between the gantry and the patient (static; NOT based on CT info).

tPLUNC simplified spreadsheet
In the teaching version, color-coding (red, green, yellow, cyan) enables us to refer to the widgets in dosimetry tutorials. The pink background is a "zebra strip" to ease reading of very wide displays (it supports your eye moving across the page).  The sheet is reduced in functionality and visually separates function button groups, clearing distinguishing buttons from outputs.

Lean Process Improvement Metrics

Electronic Whiteboard
The ewb (Electronic WhiteBoard) is a live webpage view (a "web app") of every patient undergoing planning in our clinic, across all clinicians.  It facilitates communication through big-board displays throughout a clinic.   It is used to plan work to be done next, which helps to avoid bottlenecks and "race conditions" (in which the order in which tasks are performed affects the outcome, such as slipping a delivery date). The dates are color-coded to indicate the status of each planning step relative to when that step should be accomplished in a fixed schedule (2 days to plan, 1 day to do patient QA, etc). Hovering a mouse over an item exposes details as to why the item is late.  The face photo images -- intentionally suppressed to protect patient privacy -- help clinicians more quickly identify their patients by sight (eg, if patients have the same name). HIPAA (US patient privacy rules) restrictions are accommodated by displaying a patient's initials instead of the patient's entire name, and by omitting the face photos, for example, on a board that is mounted in view of non-staff. Note: this is not included in the PLanUNC distributions, as it is clinic-specific and would not work in your environment.

This web app collects information directly from Elekta Mosaiq (Tx calendar, QCL) and from PLanUNC (plan approval status).

Kudos go to Bob Sandberg et. al., who implemented a similar board by modifying how their clinic uses QCLs and (I think) invented the key idea of negative dates (think "T-minus" in rocket launches) that allow us to count backwards in days from the first day of Tx.  Elekta sales people indicated that this negative date feature will be in Mosaiq 2.5.

July 2013: go-live on two 42" monitors in dosimetry and physician work rooms.