Radiation Therapy pulls together virtual system

The College of Health Professions successfully completed a virtual system integration by calling on a team effort from students, staff, and faculty members. 

As Texas State University students have been pulled away from traditional hospital and clinic settings due to the COVID-19 pandemic, virtual workbooks have served as a key tool to help bridge the gap between educators and their students.

Jessica Smith, clinical coordinator of Radiation Therapy, has been working on disease-specific virtual workbooks to enable the college to increase utilization of its Virtual Environment Radiotherapy Trainer (VERT) application. After lesson plans were created and used, one item was missing: Computed Tomography (CT) data to complete some workbooks. Enter Otis Johnson, a 2004 graduate who earned a bachelor’s degree in radiation therapy. Today, Johnson is a treatment application specialist at Elekta, a leader in precision radiation medicine based in Sweden.  Johnson has expertise in Monaco, a high-precision radiotherapy treatment planning program. “Jessica reached out to me to help develop a plan,” he said. “It's utilizing beams and slices of CT to be able to teach and have visuals from Monaco.”

Maintaining and upgrading multiple systems is the mission that has required input and effort from students, staff, and faculty members. “We have one system that is an electronic medical record,” said Dr. Ronnie Lozano, chair and associate professor, Radiation Therapy. “We have another system for treatment planning where students get to learn about doses for different parts of the anatomy and how to create plans for different types of tumors. 

“We have another system that is a virtual treatment machine. Students can actually see the machine, see the patient, and see the tumors. Something we always wanted to do was join these systems together so we could provide a solid workflow.”

That path goes from the starting line to acquiring anatomy – taking images – through the treatment planning system to downloading information into the mosaic electronic medical record. Then the information is imported into a virtual machine so students can form a plan and deliver the plan they have created. “We have never been able to do all that before,” Lozano said. 

Elekta donated a substantial amount of hard equipment and licenses to Texas State University to get the program up and running. Monaco was a gift from Elekta. “We have been extremely fortunate to work with companies that allow us to have an unusual number of licenses for one system,” Lozano said. “We are extremely blessed. We could have never afforded this.”

Johnson estimates one license costs about $50,000 and the server cost varies depending on facility needs and the number of employees. “In most clinics, as far as Mosaic is concerned, you have the registration portion of it, the front desk, and the staff,” Johnson said. “So, you are looking at maybe 10 times $50,000 just for the licenses. Then you have the server itself and have to maintain that. It can cost between $200,000 and $500,000, depending on how many licenses you have and how many people you have working.”

Monaco is also in the $200,000 range with the same license cost. “We did the math for Monaco and it was around $1.8 million including some of the services we provide that the school does not have to pay,” Johnson said.

Considering students are not attending those traditional hospital and clinic settings in person, the VERT lab has become a more critical piece because it is the lone source for disease-specific hands-on training. “Currently, we have one LINAC (medical linear accelerator) model available on our VERT system,” said Trina Dillard, Simulation Computer Lab Manager, and Clinical Lecturer, Radiation Therapy Program. “With the (student computing grant), we will now be able to acquire two additional units. This is wonderful. Each treatment machine has different hand pendants, table controls, and design. Having the ability to teach from different LINAC models will provide knowledge and a skill set to our students that will help them succeed.”