Skip to main content
SpringerLink
Log in

Abteilungs- und Patientenmanagement in der Strahlenheilkunde

Das Freiburger Modell

Department and Patient Management in Radiotherapy. The Freiburg Model

  • Aktuelles Forum
  • Published:
Strahlentherapie und Onkologie Aims and scope Submit manuscript

Hintergrund und Ziel:

Die Arbeit im Bereich der Strahlentherapie ist hauptsächlich dadurch geprägt, dass täglich eine Vielzahl z.T. komplexer Arbeitsabläufe bewältigt und dabei hohe Sicherheitsanforderungen erfüllt werden müssen. Dieser Sachverhalt und stetig wachsender ökonomischer Druck zwingen uns, neue Strategien zu entwickeln, die unsere Arbeitsabläufe optimieren und deren Zuverlässigkeit und Sicherheit garantieren. Da es relativ wenige strahlentherapeutische Einrichtungen gibt und das Augenmerk bislang hauptsächlich auf den beschleunigernahen Systemen (Bestrahlungsplanung, Beschleunigersteuerung usw.) lag, stehen derzeit seitens der Industrie nur wenige Systeme zur Verfügung, die geeignet wären, auch die ökonomischen, organisatorischen und administrativen Bedürfnisse der Strahlentherapie zu unterstützen.

Methodik:

Im Rahmen der Baumaßnahme „neue Strahlenklinik“ am Universitätsklinikum Freiburg wurde von den Funktionsbereichen Klinische und Administrative Informatik und Medizinische Physik in enger Zusammenarbeit mit dem ärztlichen Personal ein umfassendes Konzept zur Steuerung und Organisation einer strahlentherapeutischen Einrichtung entwickelt. Das Konzept wurde im Zuge des Neubaues und des damit verbundenen HBFG-Verfahrens (Hochschulbauförderungsgesetz) durch die Deutsche Forschungsgemeinschaft begutachtet und mit Bundesmitteln in vollem Umfang unterstützt.

Ergebnisse und Schlussfolgerung:

Voraussetzung für das Ziel, ein homogenes und umfassendes Management einer Strahlenklinik zu betreiben, war die direkte Verbindung der beschleunigernahen Seite mit der organisatorischen/administrativen Umgebung. Die dadurch entstandene gemeinsame Datenbasis und Konsistenz schafften Transparenz und ermöglichten uns erstmals die umfassende organisatorische und EDV-technische Kontrolle aller Arbeitsabläufe. Nach nunmehr 2 Jahren Vollbetrieb und Umsetzung zahlreicher Teilprojekte stehen wir unmittelbar vor dem film- und papierlosen Digitalbetrieb.

Background and Purpose:

The activities in radiotherapy are mainly affected by numerous partly very complex operational procedures which have to be completed while high safety requirements have to be fulfilled. This fact and steadily increasing economic pressure are forcing us to develop new strategies which help us to optimize our operational procedures and assure their reliability. As there are not so many radiotherapeutic institutions and the main focus, up to now, was mainly stressed on the acceleration systems (radiation planning, acceleration control), only few industrial systems are available which could also support the economic, organizational and administrative needs of radiotherapy.

Methods:

During the building operations for the “new clinic for radiotherapy” at the University Hospital Freiburg, Germany, the staff of the clinical and administrative information and the medical physicists developed, in close cooperation with the physicians, a comprehensive concept to control and organize a radiotherapeutic institution. This concept was examined during the construction phase of the new clinic and the adjoined HBFG (“Hochschulbauförderungsgesetz”) process by the “Deutsche Forschungsgemeinschaft” and financed totally by federal funds.

Results and Conclusion:

The precondition for the goal to operate a homogeneous and comprehensive management of a clinic for radiotherapy was the direct connection of the acceleration area with the organizational/administrative surrounding. The thus developed common basic dates and consistence created transparency and allowed us for the first time to control all operational procedures by EDV-technical means. After 2 years full-time operation and implementation of numerous particular projects we are now ready for film- and paperless digital work.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Literatur

  1. Adam G, Lorenzen J, Krupski G, et al. Establishing a quality management system according to DIN EN ISO 9001:2000 in an academic radiological department. Rofo 2003;175:176–82.

    PubMed  CAS  Google Scholar 

  2. Baumann M, Ehninger G, Herrmann T, et al. Setting up an interdisciplinary cancer center between the poles of internal and external interests. Z Arztl Fortbild Qualitatssich 2007;101:153–8.

    PubMed  Google Scholar 

  3. Baumann M, Klages HT. Comparison of various fractionation schedule in curative radiotherapy alone of locally advanced head and neck tumors. Strahlenther Onkol 2001;177:162–5.

    PubMed  CAS  Google Scholar 

  4. Becker G, Major J, Christ G, et al. Stereotaxic convergent-beam irradiation. Initial experiences with the SRS 200 system. Strahlenther Onkol 1996;172:9–18.

    PubMed  CAS  Google Scholar 

  5. Becker J, Janiesch C. Restrictions in process design: a case study on workflows in healthcare. In: Dumas M, Reichert M, Shan M-C, eds. Business process management workshops. Berlin–Heidelberg: Springer, 2008:323–34.

    Chapter  Google Scholar 

  6. Bender HJ, Denz C, Schleppers A. The optimization of a medicinal process and the organization of work in an operating-room. Anesteziol Reanimatol 2007;4:6–9.

    PubMed  Google Scholar 

  7. Bigang L, Ji-wu S, Weimin Z. Design and optimization of an iSCSI system. Proceedings, Grid and Cooperative Computing – GCC 2004 Workshops, GCC 2004 International Workshops IGKG, SGT, GISS, AAC-GEVO, and VVS, Berlin-Heidelberg: Springer-Verlag 2004.

    Google Scholar 

  8. Bockisch A, Beyer T, Antoch G, et al. Principles of PET/CT and clinical application. Radiologe 2004;44:1045–54.

    Article  PubMed  CAS  Google Scholar 

  9. Boda-Heggemann J, Walter C, Mai S, et al. Frameless stereotactic radiosurgery of a solitary liver metastasis using active breathing control and stereotactic ultrasound. Strahlenther Onkol 2006;182:216–21.

    Article  PubMed  Google Scholar 

  10. Boda-Heggemann J, Walter C, Mai S, et al. IGRT: bildgesteuerte Strahlentherapie. Onkologe 2006;12:365–72.

    Article  Google Scholar 

  11. Cao Q, Guo T, Xie C. The design and implement of remote mirroring based on iSCSI. Proceedings, Embedded Software and Systems, Second International Conference, ICESS 2005. Berlin–Heidelberg: Springer, 2005.

    Google Scholar 

  12. Cengiz M, Selek U, Genc M, et al. Comment on “Correlation between the treated volume, the GTV and the CTV at the time of brachytherapy and histopathologic findings in 33 patients with operable cervix carcinoma”. Radiother Oncol 2005;75:367–8, author reply 368–9.

    Article  PubMed  Google Scholar 

  13. Debus J, Pirzkall A, Schlegel W, et al. Stereotactic one-time irradiation (radiosurgery). The methods, indications and results. Strahlenther Onkol 1999;175:47–56.

    Article  PubMed  CAS  Google Scholar 

  14. Deutsche Forschungsgemeinschaft. Medizinische Bildarchivierungs- und Kommunikationssysteme (PACS). Empfehlungen der Kommission für Rechenanlagen der Deutschen Forschungsgemeinschaft zur Berücksichtigung bei Anmeldungen nach dem Hochschulbauförderungsgesetz (HBFG). Radiologe 1999;39:257–9.

    Google Scholar 

  15. Dobler B, Lorenz F, Wertz H, et al. Intensity-modulated radiation therapy (IMRT) with different combinations of treatment-planning systems and linacs. Issues and how to detect them. Strahlenther Onkol 2006;182:481–8.

    Article  Google Scholar 

  16. Eckert H, Resch KL. Quality management – quo vadis? Perspectives for quality management in hospitals. Z Arztl Fortbild Qualitatssich 2003;97: 219–26.

    PubMed  Google Scholar 

  17. Ernst-Stecken A, Lambrecht U, Mueller R, et al. Hypofractionated stereotactic radiotherapy for primary and secondary intrapulmonary tumors. First results of a phase I/II study. Strahlenther Onkol 2006;182:696–702.

    Google Scholar 

  18. Flaig M, Graeber S, Sybrecht GW. Use of HL7 to integrate a HIS-subsystem: limits and possibilities 2973. MEDINFO 2001, Proceedings of the 10th World Congress on Medical Informatics, vol 1. Amsterdam: IOS Press, 2001:730–4.

    Google Scholar 

  19. Ghandeharizadeh S, Shan G, Gahagan C, et al. An on-line reorganization framework for SAN. Proceedings, Advances in Databases and Information Systems, 10th East European Conference, ADBIS 2006, Berlin-Heidelberg: Springer-Verlag 2006.

    Google Scholar 

  20. Grabenbauer GG, Reinhold C, Kerling F, et al. Fractionated stereotactically guided radiotherapy for pharmacoresistant epilepsy. Strahlenther Onkol 2003;179:1–7.

    Article  PubMed  Google Scholar 

  21. Graubner B. ICD and OPS. Historical development and current situation 3. Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 2007;50:932–43.

    Article  CAS  Google Scholar 

  22. Guckenberger M, Flentje M. Intensity-modulated radiotherapy (IMRT) of localized prostate cancer. A review and future perspectives. Strahlenther Onkol 2007;183:57–62.

    Article  Google Scholar 

  23. Guckenberger M, Meyer J, Wilbert J, et al. Precision of image-guided radiotherapy (IGRT) in six degrees of freedom and limitations in clinical practice. Strahlenther Onkol 2007;183:307–13.

    Article  PubMed  Google Scholar 

  24. Hill S. iSCSI takes on fibre channel for the all-IP enterprise. Network Computing 2006;17:48–56.

    Google Scholar 

  25. Hof H, Hoess A, Oetzel D, et al. Stereotactic single-dose radiotherapy of lung metastases. Strahlenther Onkol 2007;183:673–8.

    Article  PubMed  Google Scholar 

  26. Jereczek-Fossa BA, Kowalczyk A, D’Onofrio A, et al. Three-dimensional conformal or stereotactic reirradiation of recurrent, metastatic or new primary tumors. Analysis of 108 patients. Strahlenther Onkol 2008;184:36–40.

    Article  PubMed  Google Scholar 

  27. Kantor G, Halimi P. Target volume (GTV and CTV) in radiotherapy. Cancer Radiother 2005;9:203.

    PubMed  CAS  Google Scholar 

  28. Kim JH, Ferziger R, Kawaloff HB, et al. A web-based rapid prototyping and clinical conversational system that complements electronic patient record system. Medinfo 2001;10:628–32.

    Google Scholar 

  29. Klose KJ, Schäfer C, Kail S, et al. KIS-RIS-PACS-Integration: der Marburger Weg. Radiologe 2005;45:671–81.

    Article  PubMed  CAS  Google Scholar 

  30. Kolovou L, Darras A, Lymbperopulos D. HL7 message handling for intra-hospital information systems 2972. CIMED2005, Proceedings of the 2nd International Conference on Computational Intelligence in Medicine and Healthcare. London: IEE, 2005:446–53.

    Google Scholar 

  31. Koncar M. HL7 standard – features, principles, and methodology 9. Acta Med Croatica 2005;59:273–6.

    PubMed  Google Scholar 

  32. Kuchenbecker J, Behrens-Baumann W. Use of an electronic patient record system at the Department of Ophthalmology, Otto-von-Guericke University of Magdeburg. Ophthalmologe 2004;101:1214–9.

    Article  PubMed  CAS  Google Scholar 

  33. Lenz R, Reichert M. IT support for healthcare processes. Proceedings, Business Process Management, 3rd International Conference, BPM 2005, Berlin-Heidelberg: Springer-Verlag 2005.

    Google Scholar 

  34. Liu TJ. A simulation study of database application in a distributed system: data replication. In: Arabnia HR, Mun Y, eds. International Conference on Parallel and Distributed Processing Techniques and Applications (PDPTA 2003), Las Vegas, June 23–26, 2003, CSREA Press 2003;2:616–20.

  35. Malysiak B. Data access in database management systems. 8th Conference on Computer Networks, Krynica, June 18–20, 2001.

  36. Mellor C. Dance the tape library reel. Storage 2002;2:10–3.

    Google Scholar 

  37. Mildenberger P, Eichelberg M, Martin E. Introduction to the DICOM standard. Eur Radiol 2002;12:920–7.

    Article  PubMed  Google Scholar 

  38. Mildenberger P, Jensch P. Use of the DICOM standard in a heterogenous environment. Incompatibility or inoperability? Radiologe 1999;39:282–5.

    Article  PubMed  CAS  Google Scholar 

  39. Muller-Bergfort S, Fritze J. Extent and use of administrative hospital data in the German DRG system. Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 2007;50:1047–54.

    Article  CAS  Google Scholar 

  40. Paulsen F, Scheiderbauer J, Eschmann SM, et al. First experiences of radiation treatment planning with PET/CT. Strahlenther Onkol 2006;182:369–75.

    Article  PubMed  Google Scholar 

  41. Pedersen S, Hasselbring W. Interoperabilität für Informationssysteme im Gesundheitswesen auf Basis medizinischer Standards. Informatik Forschung Entwicklung 2004;18:174–88.

    Article  Google Scholar 

  42. Pelikan E, Ganser A, Kotter E, et al. Experience with PACS in an ATM/Ethernet switched network environment. IEEE Trans Inf Technol Biomed 1998;2:26–9.

    Article  PubMed  CAS  Google Scholar 

  43. Robra BP, Swart E. [Preparing for the G-DRG system: portfolio analysis of the hospitals in Saxony-Anhalt, Germany.] Gesundheitswesen 2002;64:203–6.

    Article  PubMed  CAS  Google Scholar 

  44. Rudroff C, Schweins M, Heiss MM. [The quality of patient care under the German DRG system using as example the inguinal hernia repair.] Zentralbl Chir 2008;133:51–4.

    Article  PubMed  CAS  Google Scholar 

  45. Song H. Application of data replication technology in the information system. J Wuhan Univ Technol (Inform Manag Eng) 2003;25:45–9.

    Google Scholar 

  46. Stausberg J, Bartoszek G, Lottko B, et al. Problem focused integration of information, quality and process management with empirical research: the example of the Essen Interdisciplinary Pressure Ulcer Project. Stud Health Technol Inform 2006;122:609–12.

    PubMed  Google Scholar 

  47. Thusing C. Quality management in hospitals. Relevance of KTQ. Med Klin 2005;100:149–53.

    Google Scholar 

  48. Van Hee K, Schonenberg H, Serebrenik A, et al. Adaptive workflows for healthcare information systems. In: ter Hofstede AHM, Benatallah B, Paik H-Y, eds. Business process management workshops. Berlin–Heidelberg: Springer, 2008:359–70.

    Chapter  Google Scholar 

  49. Wang W-F, Ma W-H, Liu J. Effective algorithm for snapshot writing in dependent snapshot storage system. Comput Eng Appl 2007;43:21–3.

    Google Scholar 

  50. Weiler T, Hoffmann R, Strehlau-Schwoll H. Quality management and certification. Optimizing hospital procedures. Unfallchirurg 2003;106:692–7.

    CAS  Google Scholar 

  51. Weiss E, Hess CF. The impact of gross tumor volume (GTV) and clinical target volume (CTV) definition on the total accuracy in radiotherapy theoretical aspects and practical experiences. Strahlenther Onkol 2003;179:21–30.

    Article  PubMed  Google Scholar 

  52. Wiezorek T, Banz N, Schwedas M, et al. Dosimetric quality assurance for intensity-modulated radiotherapy. Feasibility study for a filmless approach. Strahlenther Onkol 2005;181:468–74.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Funktionsbereich Klinische und Administrative Informatik, Universitätsklinik für Strahlenheilkunde, Freiburg, Deutschland

    Felix Heinemann

  2. Funktionsbereich Medizinische Physik, Klinik für Strahlenheilkunde, Radiologische Universitätsklinik, Freiburg, Deutschland

    Fred Röhner & Gregor Bruggmoser

  3. Klinik für Strahlenheilkunde, Radiologische Universitätsklinik, Freiburg, Deutschland

    Marianne Schmucker, Karl Henne, Anca-Ligia Grosu & Hermann Frommhold

  4. Klinik für Strahlenheilkunde, Radiologische Universitätsklinik, Robert-Koch-Straße 3, 79106, Freiburg, Deutschland

    Felix Heinemann

Authors
  1. Felix Heinemann
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Fred Röhner
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Marianne Schmucker
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Gregor Bruggmoser
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Karl Henne
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Anca-Ligia Grosu
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Hermann Frommhold
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Felix Heinemann.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Heinemann, F., Röhner, F., Schmucker, M. et al. Abteilungs- und Patientenmanagement in der Strahlenheilkunde. Strahlenther Onkol 185, 143–154 (2009). https://doi.org/10.1007/s00066-009-1895-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00066-009-1895-x

Schlüsselwörter:

Key Words:

Search

Navigation