By Jason Freeman, Senior Director, Imaging & Radiation Oncology, Technology and Digital Solutions
We recently implemented a first-of-its-kind in the world system around a proton accelerator.
Supported by Technology and Digital Solutions, Stanford Medicine cut the ribbon April 7, 2026, on an ultracompact proton therapy that will make the advanced targeted radiotherapy more accessible to patients.
There is an incredible amount of information technology required to make something like this work.
Behind it is a network of systems including imaging, planning, scheduling, delivery and the Electronic Health Record. It requires multiple vendors, must fit into regulatory requirements, and functions within strict operational constraints. The standards exist but they were built for a different era.
As an example, we rely on Modality Worklist to move scheduling data from the Radiation Oncology Information System to the Treatment Delivery System. In doing so you are operating within constraints that do not reflect how modern systems can communicate. Those constraints directly shape the solution and they are frequently suboptimal.
The functional requirements are quite staggering. The workflow involves a unique upright CT scanner with data flowing through a DICOM unifier and into systems that support both treatment planning and radiological diagnosis.
In this case, the primary Treatment Planning System could not support the required planning. We deployed an additional TPS. It required capital approval, team formation, systems integration design and GPU-enabled on-premise distributed computing infrastructure. We connected it to our application virtualization environment so clinicians can access it globally. The solution was deployed a full year early so we could focus on the other work required.
That TPS must write back into the ROIS to align with internal processes for quality assurance, scheduling, billing and documentation. HL7 interfaces are used to synchronize with the EHR (SYN, ACK, SYN, some of you are old enough to know). It is very limited in terms of error handling; all we really know is the message got there or it did not and no idea how that data was handled. Every interface is important and requires timing, data integrity and traceability across the entire chain.
There are several amazing technologies at play here, with the star of the show being the proton accelerator. It combines a tiny superconducting accelerator with robotics and imaging technologies. This work required close coordination across our radiation oncology team including physicians, physicists, administrators and therapists and in my mind the most important part of the cross-functional team is the IT professionals.
Huge shout-out to the TDS Radiation Oncology team! Again, we delivered a first-of-its-kind clinical technology on time and on budget, on a mission to fight cancer.
