Cloud-based deployment of Varian software leads to increased flexibility and performance at predictable costs.
Never has the radiotherapy IT environment looked so complex, with busy staff under pressure to keep ever-evolving systems updated, secure, compliant, and highly available. Clinicians expect the latest tools at their fingertips and administrators expect utmost efficiency with flexibility—a combination that can be challenging for institutional IT groups, which are often servicing numerous departments within the hospital or clinic and may not have the resources to support advanced radiation oncology clinical programs.
Varian Managed Services are a unique IT solution for deploying Varian software efficiently and flexibly, through a fully hosted, cloud-based platform that easily scales to meet changing clinical needs. The offering includes the cloud IT infrastructure, software license subscriptions, and a comprehensive Service Level Agreement (SLA) that covers maintenance, support, training & software upgrades during the period of engagement.
This alternative IT infrastructure offers remote, secure access, continuous proactive monitoring, smooth and rapid upgrades, and more—in flexible options created to support a clinic’s objectives and to augment IT resources.
Managed services at the East Suffolk and North Essex NHS Foundation Trust in the UK
Recently, two hospitals in the UK—Colchester Hospital University NHS Foundation Trust and The Ipswich Hospital NHS Trust—merged into a single entity, the East Suffolk and North Essex NHS Foundation Trust (ESNEFT).
Varian’s Managed Services team has helped with the merger by streamlining radiotherapy treatment delivery to improve patient care and optimize resources. The first phase of the plan, moving Varian software—the ARIA® oncology information system and Eclipse™ treatment planning—to a cloud-based managed IT environment, is complete. Clinicians at the ESNEFT say they are already benefiting from the change, in the form of faster access to new features, better system performance, and improved flexibility.
Moving towards virtualization for system services
The project started in 2018, when the two hospitals merged. Together, these sites treated around 3,000 radiotherapy patients annually on seven Varian TrueBeam® systems, using ARIA and Eclipse installed on local servers that had to be managed by radiotherapy department staff in both places. Just as they were considering upgrading ARIA from v11 to v15, the Trust’s main IT group began moving toward virtualized environments for system services.
“We needed to replace our servers for the upgrade, so to tie into the new IT virtualization strategy we started looking at other available options,” explained Hayley James, head of Radiation Services at ESNEFT. “In comparing all the solutions, which included Varian, a third-party service, and even an in-house option where the ARIA and Eclipse servers would be hosted on the Trust cloud infrastructure, Varian’s offering came out on top, scoring highest across all our cost, risk, and ease-of-use criteria.”
Reducing risk and managing complexity
A key goal of the Trust’s IT strategy was to reduce the risks and management complexity in running the software associated with highly technical treatment delivery systems so that the IT staff could focus their efforts on more general IT infrastructure issues and network requirements across both sites. The Trust was also looking to achieve predictable costs across a 5-year plan.
Varian stepped in and coordinated the process of moving the department’s software and historical patient data to the cloud-based, managed-IT environment and managing the ARIA upgrade at the same time. All key trust stakeholders met regularly online as the project moved forward, including members of the radiotherapy department, IT, and two Varian project managers for both medical oncology and radiation oncology.
“It was a massive change for us and the work we got done was incredible,” James said. “Not only did it involve an upgrade, but we were doing it during a pandemic, trying to treat patients and implement all kinds of new guidelines and protocols. The Varian implementation team was especially helpful in setting up the systems to support our workflows and interfaces with other systems. For example, our patient demographics are fed in through an HL7 link; we have a CT scanner and a PAC system, and all those functions are critical for service delivery.”
Vigorous testing was a key prior to going live, and James and team were provided a test system in the cloud that enabled them to explore all the new features that were part of the ARIA upgrade.
“We tested each linac with data moving to and from the cloud and with all third-party systems to make sure all elements ‘talked to’ each other before going live,” James explained. “The support from Varian kept us on track and when we went live, the only difference for all staff is using their Trust credentials to log into ARIA.”
Unanticipated benefits during COVID pandemic
For James and her team, the value of having Varian host and manage the software environment has been even greater than anticipated.
“Remote access to ARIA has also been a huge unanticipated benefit during the Covid pandemic,” James added. “We’ve had people isolating who could now log in securely from home and continue treatment planning. Plus, the calculation resources in the cloud are a lot faster than the local servers we had been using, so we’re seeing some significant performance gains for functions such as plan optimization and dose calculation.”
Since the department staff no longer has to support physical servers in the building, James and team said they’re confident that future software upgrades will be easier to install and manage, freeing up time to spend focused on patient care. Furthermore, they have peace of mind when it comes to high availability since Varian monitors the software around the clock, every day.
Predictable costs based on contracted terms
For the Trust, having Varian manage its ARIA and Eclipse radiotherapy software means less risk of unexpected capital expenditures and predictable costs over the next five years, based on upfront, contracted terms.
“We didn’t always know how often we were going to need to do a hardware refresh to keep up with software updates, “ James explained. “Now we know exactly how many upgrades we’re going to get over the period of the contract with no unpleasant surprises down the line.”
As part of the Trust’s ongoing engagement with Varian Professional Services—the consulting arm of Varian’s service organization—the Trust is planning to merge the databases from the two hospitals and evaluate workflows for a completely integrated and unified paperless process across both sites in the near future.
“Varian is helping us ensure our work processes both within and outside of ARIA are consistent so we can merge the databases without any major effects on the functioning of the two departments,” James said. “Aligning the two hospitals is much easier now that ARIA and Eclipse are in the cloud. All these elements are setting us up to use what we've got properly and maximize its value. That is so much easier in the hosted environment.”
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