ABSTRACT
Currently, radiotherapy treatment is a complex process which utilizes advanced automated systems. However, until relatively recently the process was largely manual. Technologies under development, particularly in the areas of simulation modeling and treatment planning, offer the possibility of automating many of the functions that are currently carried out by radiotherapy staff. If adopted, they are likely to significantly change the roles of health care professionals. In this paper, an allocation of functions method, Levels of Automation (LOA) (Parasuraman ct al., 2000) was used as the basis for an evaluation of the impact of adopting such new technologies on radiotherapists. The star1ing point for the analysis was an IDEF0 model of the radiotherapy treatment process previously developed by the authors. A number of functions which utilize technology extensively were selected for analysis. The LOA model was applied to the way in which each function was achieved in the past, the way they arc currently achieved and the possibilities for achieving them in the future. The function allocation method proved to be useful in identifying trends in automation and also facilitated discussion among diverse
In recent years, radiotherapy has benefitted from several significant leaps in the equipment, teclmology and treatment types available for the delivery of care, e.g. the introduction of computer controlled accelerators and highly complicated software-based treatment planning models. New technology systems have been introduced that support critical treatment functionality across all aspects of the care process. Electronic Medical Records (EMR), Picture Archiving and Communication Systems (PACS), 3D treatment planning and simulation, and on-line and in-vivo dosimetry are now fundamental in supporting the delivery of new and advanced treatment types such as Intensity Modulated Radiation Therapy (IMR T) and Image Guided Radiation Therapy (IGRT) (Fallon et al., 2009a). These systems have also been introduced to support stakeholders in meeting the demands of increasing patient numbers, to facilitate more complex treatment plans and to reduce the potential risk of human errors which have been found to contribute to adverse events (Fallon et al., 2009b ). The introduction of these technologies has impacted on the roles of professionals working in radiotherapy. For example in the department studied, radiotherapists currently sign-off on some of the radiotherapy treatment plans for breast cancer. Previously, this role was uniquely done by radiation oncologists. This change in role can be attributed to the increased capacity of the system due to the implementation of advanced technology and the need to effectively utilize this capacity. Future technological change is likely to have a greater impact on these roles, resulting in the re-allocation of functions between them. It is important that all system stakeholders are aware of these implications.
