The exchange of radiotherapy data as part of an electronic patient-referral system

Purpose: To describe the implementation and use of an electronic patient-re ferral system as an aid to the efficient referral of patients to a remote a nd specialized treatment center. Methods and Materials: A system for the exchange of radiotherapy data betwe en different commercial planning systems and a specially developed planning system for proton therapy has been developed through the use of the PAPYRU S diagnostic image standard as an intermediate format, To ensure the cooper ation of the different TPS manufacturers, the number of data sets defined f or transfer has been restricted to the three core data sets of CT, VOIs, an d three-dimensional dose distributions. As a complement to the exchange of data, network-wide application-sharing (video-conferencing) technologies ha ve been adopted to provide methods for the interactive discussion and asses sment of treatments plans with one or more partner clinics. Results: Through the use of evaluation plans based on the exchanged data, r eferring clinics can accurately assess the advantages offered by proton the rapy on a patient-by-patient basis, while the practicality or otherwise of the proposed treatments can simultaneously be assessed by the proton therap y center. Such a system, along with the interactive capabilities provided b y video-conferencing methods, has been found to be an efficient solution to the problem of patient assessment and selection at a specialized treatment center, and is a necessary first step toward the full electronic integrati on of such centers with their remotely situated referral centers. (C) 2000 Elsevier Science Inc.