electronrt:instructions_for_use:instructions_for_use
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electronrt:instructions_for_use:instructions_for_use [2020/09/15 15:23] – [Local Data Storage] kerhart | electronrt:instructions_for_use:instructions_for_use [2022/09/27 17:27] (current) – [Account Permissions] dpatenaude | ||
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The decimal ElectronRT software communicates with other radiation oncology software generally by sending & receiving files in various DICOM RT formats. Since the accuracy of information computed and displayed by an application such as this is very important to the proper treatment of patients, it is critical that users have the appropriate educational and clinical experience backgrounds to adequately understand and use the product. Additionally, | The decimal ElectronRT software communicates with other radiation oncology software generally by sending & receiving files in various DICOM RT formats. Since the accuracy of information computed and displayed by an application such as this is very important to the proper treatment of patients, it is critical that users have the appropriate educational and clinical experience backgrounds to adequately understand and use the product. Additionally, | ||
+ | {{page> | ||
==== Data Management (Storage and Caching) ==== | ==== Data Management (Storage and Caching) ==== | ||
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The decimal eRT app allows for centralized patient data that is shared between multiple clients (<imgref data_overview> | The decimal eRT app allows for centralized patient data that is shared between multiple clients (<imgref data_overview> | ||
- | Patient files are stored in a folder structure that represents the organizational hierarchy of the patient data model. All patient identifying information is encrypted, | + | Patient files are stored in a folder structure that represents the organizational hierarchy of the patient data model. All patient identifying information is encrypted, |
=== Network & Local Data Cache === | === Network & Local Data Cache === | ||
- | The decimal eRT app uses calculation data caching to improve the user experience by loading results from disk rather than recomputing on demand. | + | The decimal eRT app uses calculation data caching to improve the user experience by loading results from disk rather than recomputing on demand. |
- | Using the local cache allows for the caching of calculation results to the individual user’s workstation and the network cache allows users to share calculation results among all users using the centralized patient database (e.g.: user 1 saves a plan and user 2 opens the plan on a different computer; by saving to the network cache, user 2 automatically loads in user 1’s results without having to recompute them). Reading data from the local cache allows for the fastest data load time for the end user. Refer to < | + | Using the local cache allows for the caching of calculation results to the individual user’s workstation and the network cache allows users to share calculation results among all users using the centralized patient database (e.g.: user 1 saves a plan and user 2 opens the plan on a different computer; by saving to the network cache, user 2 automatically loads in user 1’s results without having to recompute them). Reading data from the local cache allows for the fastest data load time for the end user. Refer to < |
By default when decimal eRT is installed the cache locations are set to the following: | By default when decimal eRT is installed the cache locations are set to the following: | ||
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As with any software application there is always concern with system and data integrity. decimal eRT makes use of caching at various system levels to improve performance and mitigate some of these concerns. Refer to [[electronrt: | As with any software application there is always concern with system and data integrity. decimal eRT makes use of caching at various system levels to improve performance and mitigate some of these concerns. Refer to [[electronrt: | ||
- | Since data integrity is a critical feature for application such as this, the decimal eRT app automatically and continuously saves both the state of the application and the working record data on a timer (triggering every minute or less) as well as on exit of any create or edit event in the application. Additionally, | + | Since data integrity is a critical feature for application such as this, the decimal eRT app automatically and continuously saves both the state of the application and the working record data on a timer (triggering every minute or less) as well as on exit of any create or edit event in the application. Additionally, |
=== File Security === | === File Security === | ||
- | decimal eRT data files (including but not limited to: organization, | + | The following table describes the file security methods used for decimal eRT data. The subsequent paragraphs provide supplemental details for each item. |
- | Workstation level disk encryption (e.g.: bitlocker) is recommended to protect against authorized file access of file storage and calculation caches. | + | ^ Item ^ Storage Type ^ |
+ | | Patient Database | ||
+ | | ::: | Fields Containing PHI/ | ||
+ | | Patient/ | ||
- | **Note**: The [[electronrt: | + | All PHI/PII data (including data files and database fields) is encrypted using AES-256 with an encryption key that is unique for each organization/ |
+ | * **decimal eRT data files:** (includes but is not limited to: organization, | ||
+ | * **decimal eRT patient database:** Database is encrypted using AES-256. Additionally, | ||
+ | |||
+ | **Note**: The [[electronrt: | ||
=== Data Import/ | === Data Import/ | ||
Patient data is imported and exported using the DICOM NEMA 2020 standard to ensure the data is transferred error free and securely. Refer to the decimal eRT {{: | Patient data is imported and exported using the DICOM NEMA 2020 standard to ensure the data is transferred error free and securely. Refer to the decimal eRT {{: | ||
=== Data Backup Recommendations === | === Data Backup Recommendations === | ||
- | Since the ElectronRT | + | Since the decimal eRT app stores data on local file storage on each customer' |
- | There are 4 major components for the ElectronRT | + | There are 4 major components for the decimal eRT app that should be considered for data backup |
^ Data ^ Severity of Data Loss ^ Recommended Frequency | ^ Data ^ Severity of Data Loss ^ Recommended Frequency | ||
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| 4. Local (client) Data Cache | Low | | 4. Local (client) Data Cache | Low | ||
- | .decimal recommends Patient Database [1] and Patient File Storage [2] backups as frequent as possible, at least nightly, to ensure there is no substantial dataloss or interruption of software use. If the [4] Local Data Cache is lost on each workstation the [3] Network Data Cache will be fallen back to by the ElectronRT | + | .decimal recommends Patient Database [1] and Patient File Storage [2] backups as frequent as possible, at least nightly, to ensure there is no substantial dataloss or interruption of software use. If the [4] Local Data Cache is lost on each workstation the [3] Network Data Cache will be fallen back to by the decimal eRT app. So backup of this data is not necessary. Refer to [[electronrt: |
- | It's also recommended that prior to testing/deploying a new release version | + | It's also recommended that prior to deploying a new release version, a full [[electronrt: |
=== Internet Data Transfer === | === Internet Data Transfer === | ||
- | Since the primary purpose | + | Since electron therapy generally requires frequent use of patient-specific |
< | < | ||
- | Data is transferred to and from the decimal Direct | + | Data is transferred to and from the decimal Direct |
+ | |||
+ | === Simultaneous Plan Access === | ||
+ | |||
+ | Treatment plans are protected against simultaneous record access and data loss by ensuring an attempted update to plan data is not based on an outdated base file. If the local plan record has been accessed simultaneously by another user and has been modified (committed to the database) by another user, the outdated local plan record will be unable to commit the change until the plan has been updated locally. | ||
==== Coordinates and Units of Measure ==== | ==== Coordinates and Units of Measure ==== | ||
The following is a list of several important items that users should understand in regards to the information displays in the decimal eRT application: | The following is a list of several important items that users should understand in regards to the information displays in the decimal eRT application: | ||
- | * decimal eRT exclusively uses DICOM coordinate | + | * decimal eRT exclusively uses the DICOM patient |
+ | * Local equipment coordinates are available for machine rotational axes (i.e. gantry, couch, and collimator) and users should configure each treatment room to match their actual equipment using decimal eRT site level settings at the time of commissioning | ||
* All linear dimensions are shown in centimeters (cm) | * All linear dimensions are shown in centimeters (cm) | ||
* All angular dimensions are shown in degrees (deg) | * All angular dimensions are shown in degrees (deg) | ||
* All radiation dose quantities will be shown with their corresponding units within the application (e.g. Gy or %) | * All radiation dose quantities will be shown with their corresponding units within the application (e.g. Gy or %) | ||
- | * All date/time values are provided in a // dd/mm/yyyy h:m:s // format using local time on a 24 hour clock | + | * All date/time values are provided in a // yyyy-mm-dd |
* All date and time notifications in decimal eRT should match current Windows OS date and time, including proper use of daylight savings time where appropriate (note: decimal eRT will display in 24 hour format, while Windows may display in am/pm depending on local settings) | * All date and time notifications in decimal eRT should match current Windows OS date and time, including proper use of daylight savings time where appropriate (note: decimal eRT will display in 24 hour format, while Windows may display in am/pm depending on local settings) | ||
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==== Data Validation and Limits ==== | ==== Data Validation and Limits ==== | ||
- | Users are responsible for inputting a lot of data into the decimal eRT to develop clinical treatment plans. In the course of entering such data, there are opportunities for users to enter incorrect information. Although users are responsible for checking for such errors before clinical treatment, decimal eRT does provide some assistance in ensuring data limitations are met by a plan. Machine energy | + | Users are responsible for inputting a lot of data into decimal eRT to develop clinical treatment plans. In the course of entering such data, there are opportunities for users to enter incorrect information. Although users are responsible for checking for such errors before clinical treatment, decimal eRT does provide some assistance in ensuring data limitations are met by a plan. Machine energy, beam treatment angle limits, applicator |
- | Despite these many data validation checks, some entries, are not validated within the decimal eRT user interface and users should include appropriate checks and warnings in their custom treatment plan reports to ensure such concerns are brought to the attention of all responsible parties before patient treatment begins. | + | Despite these many data validation checks, some entries are not able to be validated within the decimal eRT user interface and users should include appropriate checks and warnings in their custom treatment plan reports to ensure such concerns are brought to the attention of all responsible parties before patient treatment begins. |
- | + | ||
- | Such warnings | + | |
=== Max number of Supported beams === | === Max number of Supported beams === | ||
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=== Commissioning Data Field Sizes === | === Commissioning Data Field Sizes === | ||
- | The decimal eRT app UI will provide a warning to the user if a beam's field size is larger or smaller than the allowable field sizes listed in the commissioning data for the selected beam energy. The warning will appear in the Beams Block next to each beam and as a warning on the Treatment Plan PDF report. | + | The decimal eRT app UI and plan reports |
==== Data Displays and Interpretation ==== | ==== Data Displays and Interpretation ==== | ||
- | <WRAP center round todo 60%> | + | |
- | KEVIN FIXME | + | The decimal eRT app is a complex treatment planning system and as such it contains many different |
- | Do this section | + | |
- | </ | + | |
- | Astroid | + | |
==== Unauthorized Use ==== | ==== Unauthorized Use ==== | ||
- | The decimal eRT application will contain sensitive patient information that is protected under various governmental regulations, | + | The decimal eRT application will contain sensitive patient information that is protected under various governmental regulations, |
- | Currently the password policy | + | Currently the .decimal authentication systems |
- | * At least 1 special character | + | * At least 1 special character |
* Lower case (a-z), upper case (A-Z) and numbers (0-9) | * Lower case (a-z), upper case (A-Z) and numbers (0-9) | ||
- | * Must have 10 characters in length | + | * Must be at least 10 characters in length |
==== Access Control ==== | ==== Access Control ==== | ||
- | decimal eRT uses [[https:// | + | decimal eRT uses [[https:// |
- | Idle workstation locking | + | As decimal eRT is deployed on customer workstations the site administrator will be responsible |
=== User Authentication === | === User Authentication === | ||
Users authenticate and launch the decimal eRT application using the [[decimalauncher: | Users authenticate and launch the decimal eRT application using the [[decimalauncher: | ||
- | == User Sessions == | + | === User Sessions |
- | When decimal eRT is launched from the decimal Launcher, decimal eRT is given an JWT authentication token for the logged in user. This token is used to authenticate and perform [[https:// | + | When decimal eRT is launched from the decimal Launcher, decimal eRT is given an JWT authentication token for the logged in user. This token is used to authenticate and perform [[https:// |
- | == Inactivity Timeout == | + | Auth0 user credentials are authenticated and validated using the decimal Direct API by decimal eRT each time a user logs in and on recurring timer events. If user credentials are invalid or expired, users will automatically be logged out of the application and prevented from using or accessing any data within the application/ |
- | decimal eRT has a built in inactivity timeout that will automatically log the user out if no mouse/ | + | === Inactivity Timeout === |
+ | |||
+ | decimal eRT has a built in inactivity timeout that will automatically log the user out if no mouse/ | ||
=== Account Management === | === Account Management === | ||
- | decimal eRT uses [[https://auth0.com/security|Auth0]] as an Identity as a Service provider for user account | + | decimal eRT site managers have the ability to [[https://direct.dotdecimal.com/guide# |
- | Auth0 user credentials are authenticated and validated using the decimal Direct API by decimal eRT each time a user logs in and on recurring timer events. If user credentials are invalid or expired users will automatically be logged out of the application and prevented from using or accessing any data within the application/ | + | === Account Permissions === |
- | decimal eRT site managers have the ability to [[https:// | + | Account permissions are able to be set by the Site Administrator within |
+ | - **User Levels**: A high level generic group for the user that provides general | ||
+ | - **Feature Permissions**: A feature by feature granular permission | ||
- | === Account Permissions === | + | == User Levels |
- | decimal eRT limits the features available to users based on their .decimal account permission level: | + | decimal eRT limits the features available to users based on their .decimal account |
^ Permission Level ^ Available Permissions ^ | ^ Permission Level ^ Available Permissions ^ | ||
| **Default | | **Default | ||
| **Research | | **Research | ||
- | | **Physics | + | | **Elevated |
+ | |||
+ | == Feature Permissions == | ||
+ | |||
+ | In addition, eRT also provides user based permissions for specific features within the application. | ||
+ | |||
+ | ^ Permission | ||
+ | | **IM Device** | Site Wide | Allows the user to use the Electron Intensity Modulator devices when making a beam. \\ //This permission is granted by .decimal staff on the purchase of the Electron Intensity Modulator module// | ||
+ | | **Plan Approval** | User Account | Allows the user to approve and lock treatment plans required to order hardware devices for fabrication | | ||
+ | | **Facility Configuration** | User Account | Allows the user to edit the Organization and Treatment machines, including commissioning data | | ||
- | As decimal eRT is deployed on customer work stations the site administrator will be responsible for the installation of the software on the appropriate workstations and the account management of all users at the facility. Each employee should have an individual login and password to access the decimal eRT application that prevents authorized access, and account sharing is strictly prohibited. | ||
==== Known Limitations ==== | ==== Known Limitations ==== | ||
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- Ensures that the local app client stays in sync with the latest release version (as set via decimal Direct) | - Ensures that the local app client stays in sync with the latest release version (as set via decimal Direct) | ||
- Provides user authentication and password management | - Provides user authentication and password management | ||
- | - Provides binary file security to ensure that the application files are not tampered with on .decimal' | + | - Provides binary file security to ensure that the application files are not tampered with on .decimal' |
When an application update is available via the decimal Launcher, the users will be required to install the app in the Launcher. This is accomplished by selecting the // | When an application update is available via the decimal Launcher, the users will be required to install the app in the Launcher. This is accomplished by selecting the // | ||
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=== Releasing a new App Version === | === Releasing a new App Version === | ||
- | When a new application version of decimal eRT is released users will be notified in the [[decimalauncher: | + | When a new application version of decimal eRT is released, users will be notified in the [[decimalauncher: |
New release versions of the decimal eRT application should be tested prior to clinical deployment following the [[electronrt: | New release versions of the decimal eRT application should be tested prior to clinical deployment following the [[electronrt: | ||
- | Once an app version has been reviewed and approved for release at a site, the application will be deployed to the decimal Launcher clinical environment | + | Once an app version has been reviewed and approved for release at a site, the application will be deployed to the decimal Launcher clinical environment |
=== Release Notes === | === Release Notes === | ||
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* Test the final dose calculations of matching patients between the two app versions to ensure the final doses exactly match (unless the app release notes has been otherwise indicated that the dose calculations have changed). | * Test the final dose calculations of matching patients between the two app versions to ensure the final doses exactly match (unless the app release notes has been otherwise indicated that the dose calculations have changed). | ||
- | Prior to releasing a new app version into a site, it is imperative to ensure that the data is compatible between the existing version installed in the clinical environment and the new version that is intended to be installed | + | Prior to releasing a new app version into a site, it is imperative to ensure that the data is compatible between the existing version installed in the clinical environment and the new version that is intended to be installed. This should be tested according to the [[electronrt: |
=== Testing New Releases === | === Testing New Releases === | ||
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The following procedure shall be followed in order to safely release new versions of an application: | The following procedure shall be followed in order to safely release new versions of an application: | ||
- | - Perform [[electronrt: | + | - Perform [[electronrt: |
- | - While this step should be unnecessary, | + | - While this step should be unnecessary, |
- | - Review the release notes for the new version and ensure you understand the changes and acknowledge any risks of deployment of the new version to your site | + | - Review the release notes for the new version and ensure you understand the changes and acknowledge any risks of deployment of the new version to your site. |
- | - Install the release candidate version of the application to the [[decimalauncher: | + | - Install the release candidate version of the application to the [[decimalauncher: |
- Open existing patients in the Sandbox environment. You should ensure each of the following for the existing patients and plans in the sandbox testing: | - Open existing patients in the Sandbox environment. You should ensure each of the following for the existing patients and plans in the sandbox testing: | ||
- The patients and plans all open without errors. | - The patients and plans all open without errors. | ||
- The final dose result is the same as the previous version. Note: for unapproved plans the dose results may recompute. For approved plans the dose and device results should be exactly the same. | - The final dose result is the same as the previous version. Note: for unapproved plans the dose results may recompute. For approved plans the dose and device results should be exactly the same. | ||
- | - Perform any testing deemed appropriate in regards to the changes outlined in the release notes and required by regulatory guidelines for treatment planning system upgrades. | + | - **Perform any testing deemed appropriate in regards to the changes outlined in the release notes and required by regulatory guidelines for treatment planning system upgrades**. |
- | - Once the release candidate has been thoroughly tested and is ready for release, notify all users at your site of the pending release and set an appropriate date and time for the release (it is generally good practice to stop all active clinical use during the upgrade so choose a time outside of normal clinical operating hours). At the designated date/ | + | - Once the release candidate has been thoroughly tested and is ready for release, notify all users at your site of the pending release and set an appropriate date and time for the release (it is generally good practice to stop all active clinical use during the upgrade, so it is best to choose a time outside of normal clinical operating hours). At the designated date/ |
- | - Using the decimal Launcher [[decimalauncher: | + | - Using the decimal Launcher [[decimalauncher: |
==== Data Duplication or Backup ==== | ==== Data Duplication or Backup ==== | ||
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=== Copying Data === | === Copying Data === | ||
- | The current data storage locations are set in the decimal eRT [[electronrt: | + | The current data storage locations are set in the decimal eRT [[electronrt: |
=== Linking to New Data Storage === | === Linking to New Data Storage === | ||
- | To restore or link to a different data store open the decimal eRT [[electronrt: | + | To restore or link to a different data store, open the decimal eRT [[electronrt: |
===== decimal eRT Patient Data Model ===== | ===== decimal eRT Patient Data Model ===== | ||
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- Contains the physician' | - Contains the physician' | ||
- **Plan(s)** | - **Plan(s)** | ||
- | - A detailed model of a electron therapy treatment. Most aspects of the patient planning information are stored here (e.g. Beams, Devices, Dose). A Plan will implement all of the Course prescription and physicians will approve a Plan to indicate it is ready to proceed to QA and (if successful) on to actual patient treatment. | + | - A detailed model of an electron therapy treatment. Most aspects of the patient planning information are stored here (e.g. Beams, Devices, Dose). A Plan will implement all of the Course prescription and physicians will approve a Plan to indicate it is ready to proceed to QA and (if successful) on to actual patient treatment. |
- | - A Plan also contains a QA record (once the plan is approved) that allows | + | - A Plan also contains a QA record (once the plan is approved) that facilitates completion of plan dose QA and device QA. |
==== Hierarchy ==== | ==== Hierarchy ==== | ||
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===== System Requirements ===== | ===== System Requirements ===== | ||
- | Details regarding the specific requirements for computers on which the decimal Launcher and decimal eRT client applications will be installed can be found on the [[decimalauncher: | + | Details regarding the specific requirements for computers on which the decimal Launcher and decimal eRT client applications will be installed can be found on the [[decimalauncher: |
+ | |||
+ | |||
+ | ---- | ||
+ | |||
+ | <WRAP centeralign> | ||
+ | //decimal eRT® is a trademark of .decimal, LLC.// \\ | ||
+ | |||
+ | 121 Central Park Place, Sanford, FL 32771 \\ 1-800-255-1613</ |
electronrt/instructions_for_use/instructions_for_use.1600183433.txt.gz · Last modified: 2021/07/29 18:21 (external edit)