ProKnow cloud-based system for radiotherapy data storage, communication and management: early value assessment

ProKnow is a system used in radiotherapy offering a cloud-based data repository, communication tools and analytics software. The technology is used for people having image-guided 3D planned radiotherapy, and allows centres to compare radiotherapy plans and collect images and dosimetric data. ProKnow can be used to view treatment plan information, visualise images and the structures they contain, and inspect dosimetric data, such as dose volume histograms and dose distributions. Custom treatment plan quality metrics can be extracted, such as data on local radiotherapy control, survivorship, and side effects. ProKnow allows teams to work together to mark the areas of interest on images, in a process known as contouring. This can be done from any computer without the need for a dedicated workstation, so it allows collaboration and peer review of treatment plans between centres that are using ProKnow. At present, ProKnow is not used for brachytherapy, radionuclide therapy or 4D datasets.

The comparator is standard care, which varies across centres. Most radiotherapy departments have local radiotherapy protocols specifying the technique and dose for each tumour site. Treatment planning involves clinical oncologists, radiographers, dosimetrists and medical physicists, with the qualified clinical oncologist taking overall responsibility for planning and final sign-off. Peer review is an important step in treatment planning to ensure the proposed plan will deliver safe and effective treatment, and to identify issues that could affect quality of care. The peer review process is also intended to improve standardisation and reduce variation in practice, and improve knowledge sharing between healthcare professionals involved in treatment planning.

The Royal College of Radiologists' (RCR) guidance on radiotherapy target volume definition and peer review (2022) says that departments should have agreed radiotherapy protocols for each tumour subsite. These protocols should include target volume guidelines, be agreed by the departments working together, and should be standardised across operational delivery networks, as well as nationally or internationally if possible. There are several different methods, software and technologies used for peer review in NHS practice.

In March 2022, NHS England commissioned a pilot of ProKnow across 49 specialist cancer centres with funding provided until March 2025.