Purpose: Personalized ultra-fractionated stereotactic adaptive radiotherapy (PULSAR) is a promising radiation therapy paradigm taking advantage of the clinically proven effectiveness of stereotactic ablative radiotherapy (SAbR) and the opportunity to adapt more effectively with long intervals (weeks to months) between individual SAbR treatments (pulses). However, the long time between consecutive pulses creates a management challenge to the care team. A specialized whiteboard application was developed to oversee the process of PULSAR treatments to ensure patient treatment is completed correctly.
Methods: The web-based whiteboard application was designed to track the whole process of treatment planning and delivery throughout the entire course of PULSAR. When the prescription and timing is defined, tasks for the entire course will be automatically scheduled. Responsible parties will be reminded of upcoming work via email and page based on the due dates. The patient’s progress is visually presented to optimize effectiveness and ease of use. The whiteboard application is connected to databases of clinical information systems for automatic data acquisition.
Results: A whiteboard application was developed in the ecosystem of our in-house applications. It is drastically different from any in-house or commercial system in a) visually presenting the progress of the entire patient treatment and within each pulse; b) automatically laying out schedules of the entire course; c) automatically updating some of the statuses and sending reminders to responsible parties. Functions for access control and audits are also embedded in this application to ensure safety and a smooth workflow.
Conclusion: The PULSAR whiteboard application is a feasible means to organize and track PULSAR treatments. It helps the care team carry out non-conventional adaptive radiation therapy treatments on schedule. Profession-sensitive whiteboards and analytics tools can also be added for higher efficiency and better workflows.