ASTROnews: Radiation Therapy Equipment Vendors Unite at third annual IHE-RO Connectathon

ASTRO hosted the third annual IHE-RO Connectathon on September 15 - 22, 2009, at ASTRO headquarters in Fairfax, Va. Ten companies came to test the integration of their equipment and prove they can meet interconnectivity standards and operate with each other.

But, it wasn’t easy. The overwhelming response from this year’s participants was that the Connectathon is getting more difficult, but in a good way.

“It’s been challenging; far more challenging,” Stuart Swerdloff, Ph.D., an Elekta representative at the Connectathon, said. “It should be getting harder though. If we set the bar in a place where everyone can reach it, then why aren’t we there already?”

Integrating the Healthcare Enterprise – Radiation Oncology (IHE-RO) was established in 2004, during Prabhakar Tripuraneni, M.D., FASTRO’s, ASTRO presidency as a domain of the larger Integrating the Healthcare Enterprise (IHE) program, an initiative created by healthcare professionals and industry to improve the way computer systems in healthcare share information. In addition to radiation oncology, there are operational domains in eye care, cardiology, radiology and patient care devices, to name a few. The IHE-RO Connectathon tested its first profile in 2007.

“We have the experts here together [at the Connectathon],” Ulrich Busch, a Varian representative at the Connectathon, said. “We can solve problems that we otherwise wouldn’t be able to.”

The IHE-RO process begins with the IHE-RO Planning Committee, which sends a request for use cases to the radiation oncology community. According to Bruce Curran, M.E., an IHE-RO planning committee member and Technical Committee co-chair, a use case illustrates issues that arise in radiation oncology practice that could be solved through improved interoperability.

A description outlining the problems presented by each use case and other technical details is then posted to the IHE-RO Planning Committee Wiki for committee members to review. After several discussions on the use cases, committee members vote to prioritize the importance and significance of each, and the top three are submitted to the Technical Committee.

The Technical Committee takes the information prepared by the Planning Committee, constructs a solution, and writes a Technical Framework (technical documentation of the solution) that is used by manufacturers to solve interoperability problems. The Technical Framework provides the basis for the interoperability testing that occurs during the Connectathon.

“The point of it all is to have a standards-based method for machines to be able to communicate with each other to treat patients and to create an environment in which an electronic healthcare record can function and be useful, so we can give patients the best care,” Curran said.

The 2009 Connectathon participants were Accuray, BrainLAB, Elekta, GE Healthcare, Nucletron, Philips, Tomotherapy, Siemens, Varian, and MIMVista. They tested against the 2007 profile, “Basic RT Objects Interoperability,” the 2008 profile, “Multimodality Image Registration for Radiation Oncology,” and two new profiles: “Advanced RT Objects Interoperability” and “Integrated Positioning and Delivery Workflow.”

The Integrated Positioning and Delivery Workflow profile testing was not conclusive due to an insufficient number of vendors participating. However, Accuray and Tomotherapy were acknowledged for their leadership efforts in the development and initial testing on this profile, according to Curran.

All vendors were successful for at least one of the roles their products played during the Connectathon. Prior to the Connectathon, vendors were required to pass a series of initial tests using the IHE-RO test suite, which is computer software used to validate the base functionality of the products.

During the Connectathon, participants must demonstrate, for each aspect of their products being tested, three successful interactions with complementary systems. Curran said issues are sometimes found on initial attempts, but vendors often can identify and repair the problem on site, then retest.

Curran also said it is very expensive for manufacturers to fix interoperability problems at customer sites, so IHE-RO provides a less expensive and more effective way for them to correct these problems by allowing them to be tested prior to reaching the customer.

Once a vendor passes a Connectathon, they release an integration statement to show potential customers that their equipment has been tested for compatibility with other vendors’ equipment.

According to Curran, an increasing number of customers are requiring that vendors show proof that they have passed an IHE-RO Connectathon before their products can be considered for use in their cancer centers.

And according to most IHE-RO participants, the goal for this testing is for the vendors to use this new technology to ultimately provide patients with better care.

Curran said, “The difference that [IHE-RO] has made is starting to be apparent in the clinic, which is of course the goal we are all striving for.”

-Nicole Napoli, Publications Specialist

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