Specialty

Medical Oncology

A course of chemotherapy is a schedule that has to survive counts, money and drug availability for months, in a country where most of the bill is paid out of the family's own pocket. The schedule itself usually lives on a printed protocol and in one nurse's head, so a cycle slips and nobody knows until the patient is already in the day care chair.

A regimen is a schedule, and a schedule is an object.

The protocol is a document. The cycle is a set of orders. The dose is arithmetic on a body surface area that changes. The delay is a decision taken on a count that came back this morning. Written down, those four are four different pieces of paper held by four different people.

Eliminate the printed protocol that a nurse re-checks by hand at every cycle. Quest turns each ordered dose into a task with a due time, marks it given, missed or skipped, and keeps that history where the next decision is taken.

Impact and action

The cycle.

Every cycle is re-entered from the protocol, so the twelfth cycle is as much typing as the first, and each retype is a chance to differ from the eleven before it.The cycle is an order set placed once and tracked from placement to completion, carrying its own charge and its own fulfilment.Forge
Dose and interval are worked out at the chair against a paper chart.Doses stand as scheduled tasks with due times, and the staff member on shift sees the ones that are theirs.Quest

The guardrail.

A duplicate order, a cumulative limit or an interaction is caught by whoever happens to be alert at the moment it is placed.The rules for when a warning fires are defined by the hospital, and a warning that goes unacknowledged escalates up a chain of people.Sentinel

The tumour board.

The decision that governs the next six months is taken in a meeting and written into minutes the record never sees.Staging and the board's decision are captured as forms attached to the record, locked when finished, so the reason for the regimen sits beside the regimen.GlyphAtlas

The money, over months.

Treatment stops when a family runs out, and the hospital learns about it at the missed appointment.Deposits, part payments, scheme cover and the estimate against the running bill are all held on the same account the orders charge to.Vault
The reminder for the next cycle is a phone call somebody makes when there is time.Reminders go out on the channel the patient chose, inside quiet hours, on approved wording, with a delivery log.Raven

One cycle

What the platform is holding while the patient is in the chair.

Counts return
The result reaches the record and the rule that reads it.
The cycle is released or held
The decision is recorded against the cycle, with its author and its time.
Doses become due tasks
Each one has a time, an owner on the roster, and a state.
The charge lands
The chargeable order puts its charge on the account as it is placed.
The next cycle is scheduled
A due date, and a reminder on a consented channel.

A cytotoxic dose being drawn under controlled conditions. — The dose is prepared once. The record of preparing it should be created once too.

The board decides, the schedule carries, and the family pays as it goes.

Cancer treatment is the longest running process a hospital owns, and the one most often held together by a person rather than by a system.

Two things have moved outcomes in this specialty without changing the drug: a plan taken by a multidisciplinary team rather than by one clinician, and a symptom reported between visits that reaches somebody able to act on it.

Move past the symptom call that lands on a ward telephone. Glyph carries the reported form, Sentinel raises it against an owner with an escalation chain, and Raven delivers on the channel the patient chose, inside quiet hours, on approved wording, with a delivery log.

An infusion stand and a hanging bag in a day care bay. — A cycle is four hours in a chair and six months of arithmetic around it.

What Indian oncology adds

The money is part of the treatment plan.

Households pay a large share of the bill directly, so the decision to continue is taken at the counter rather than in the clinic.Deposits, part payments, scheme cover and the estimate against the running bill sit on the account the orders charge to, visible before the next cycle is booked.Vault
A cycle billed against a national scheme, a state scheme and a corporate credit book is three desks doing the same work three ways.One clinical event produces all of them, on one tariff engine, with a tamper-proof trail behind every transaction.Vault

The drug has to be in the room.

A cycle is deferred because a vial is out of stock, and the shortage is discovered on the morning the patient travels in.The catalogue belongs to the hospital, an order is locked to exactly what was ordered when it was placed, and what is in use is an object in the digital twin of the hospital.Forge

The week between cycles.

A patient with a fever rings a number and describes it to whoever answers, and the note reaches the record if somebody writes it down.The report is a form on the record, and a threshold on that form raises an owned alert rather than a line in a diary.GlyphSentinel

A row of automated analysers along a laboratory bench. — The count that releases the cycle is produced here and read three floors away.

Published research

What the literature measured, and who measured it.

Findings from hospitals that had never heard of Pensieve. They describe what the mechanism above is aimed at, and none of them is a result of ours.