Dosimetrist/Physicist Training Guide - UCSF Radiation Oncology

MOSAIQ 

Dosimetrist/Physicist 

Training Guide 

Version 1.60 

Module III: Treatment Calendar and Chart 

Check

Dosimetrist/Physicist 

Training Guide 

MOSAIQ 

Oncology Management System 

Version 1.60 

Module III: Treatment Calendar and Chart Check 

Copyright 2009 

All Rights Reserved 

IMPAC Medical Systems

PUBLISHED BY: 

IMPAC Medical Systems, Inc. 

100 Mathilda Place, Fifth Floor 

Sunnyvale, CA 94086 

COPYRIGHT 2009 by IMPAC Medical Systems 

All Rights Reserved 

Instructional Designer/Writer: Robin Bonke 

LTGRAD0005C – 1.0 – 3/31/2009 

This manual contains proprietary information to be used exclusively 

by customers of IMPAC Medical Systems. All rights reserved. 

No part of the contents of this book may be reproduced or transmitted 

in any form or by any means without the written permission 

of IMPAC Medical Systems.

Table of Contents 


Table of Contents ........................................................................................................................................................................................ i 

Introduction..................................................................................................................................................1 

What’s In This Course...............................................................................................................................................................................1 

SupportPlus Online....................................................................................................................................................................................2 

Document Conventions.............................................................................................................................................................................2 

Text Conventions ......................................................................................................................................................................................2 

Mouse Conventions...................................................................................................................................................................................2 

Keyboard Conventions...............................................................................................................................................................................2 

Lesson 9 Treatment Calendar....................................................................................................................2 

Objectives.....................................................................................................................................................................................................2 

Adding Treatment Sessions for a Single Prescription ..........................................................................................................................2 

Removing Treatment Sessions from the Treatment Calendar............................................................................................................2 

Scheduling Treatment Sessions for Multiple Prescriptions..................................................................................................................2 

Scheduling Treatment Sessions for a Single Prescription with an Alternating Pattern..................................................................2 

Scheduling Ad Hoc BID Treatment Sessions.........................................................................................................................................2 

Scheduling Overlapping Treatment Sessions.........................................................................................................................................2 

Working with Treatment Fields in the Treatment Calendar..............................................................................................................2 

Adding a Treatment Field to an Established Treatment Calendar.........................................................................................................2 

Changing the Treatment Order in the Treatment Calendar..................................................................................................................2 

Removing a Treatment Field from the Treatment Calendar..................................................................................................................2 

Replacing a Treatment Field in the Treatment Calendar........................................................................................................................2 

Working with Portal Images .....................................................................................................................................................................2 

Adding a Portal Image to an Established Treatment Calendar..............................................................................................................2 

Removing a Portal Image .........................................................................................................................................................................2 

Adding a Series of Portal Images to an Established Treatment Calendar.............................................................................................2 

Changing Treatment Session Due Dates................................................................................................................................................2 

Changing All Treatment Session Due Dates...........................................................................................................................................2 

Making an Ad Hoc Treatment Session Date Change............................................................................................................................2 

Changing a Single Treatment Session Due Date....................................................................................................................................2 

Moving a Treatment Session to the End of the Treatment Calendar ..................................................................................................2 

Working with Treatment Sessions from the Treatment Calendar....................................................................................................2 

Approving a Treatment Session ...............................................................................................................................................................2 

Closing an Incomplete Calendar Session..................................................................................................................................................2 

Scheduling Treatment Sessions with Incomplete Information ................................................................................................................2 

Adding a Field Group First When Scheduling Treatment Sessions .........................................................................................................2 

Scheduling AFS Treatment Sessions.........................................................................................................................................................2 

Scheduling MFS Treatment Sessions .......................................................................................................................................................2 

Scheduling a QA Mode Treatment Session.............................................................................................................................................2 

What's Next.................................................................................................................................................................................................2 

Copyright 2009, IMPAC Medical Systems i 

LTGRAD0005C/1.0/31-Mar-2009

MOSAIQ Dosimetrist/Physicist Training Guide Module III 

Quick Version..............................................................................................................................................................................................2 

Scheduling Treatment Sessions for a Single Prescription........................................................................................................................2 

Scheduling Treatment Sessions for Multiple Prescriptions......................................................................................................................2 

Scheduling Treatment Sessions for a Single Prescription with an Alternating Pattern ..........................................................................2 

Scheduling Ad Hoc Treatment Sessions ..................................................................................................................................................2 

Scheduling Treatment Sessions for Overlapping Treatments.................................................................................................................2 

Adding a Treatment Field to an Established Treatment Calendar.........................................................................................................2 

Changing the Treatment Order in the Treatment Calendar..................................................................................................................2 

Removing a Treatment Field in the Treatment Calendar.......................................................................................................................2 

Replacing a Treatment Field in the Treatment Calendar........................................................................................................................2 

Adding a Portal Image to an Established Treatment Calendar..............................................................................................................2 

Adding a Series of Portal Images to an Established Treatment Calendar.............................................................................................2 

Removing a Portal Image .........................................................................................................................................................................2 

Changing All Treatment Session Due Dates...........................................................................................................................................2 

Making an Ad Hoc Treatment Session Date Change............................................................................................................................2 

Changing a Single Treatment Session Due Date....................................................................................................................................2 

Moving a Treatment Session to the End of the Treatment Calendar ..................................................................................................2 

Approving a Treatment Session ...............................................................................................................................................................2 

Closing an Incomplete Calendar Session..................................................................................................................................................2 

Scheduling Treatment Sessions with Incomplete Information ................................................................................................................2 

Adding a Field Group First When Scheduling Treatment Sessions .........................................................................................................2 

Scheduling AFS Treatment Sessions.........................................................................................................................................................2 

Scheduling MFS Treatment Sessions .......................................................................................................................................................2 

Scheduling a QA Mode Treatment Session.............................................................................................................................................2 

Lesson 10 eCHART Chart Check.............................................................................................................2 

Objectives.....................................................................................................................................................................................................2 

Reviewing the eCHART Chart Check.....................................................................................................................................................2 

Reviewing eCHART Chart Check Notes................................................................................................................................................2 

What’s Next................................................................................................................................................................................................2 

Quick Version..............................................................................................................................................................................................2 

Running and Reviewing the eCHART Chart Check .................................................................................................................................2 

Reviewing eCHART Chart Check Notes ..................................................................................................................................................2 

Appendix A Getting Your System Started...............................................................................................2 

Option 1: Add the Prescription, Manually Record Treatments, Then Treat Remaining Fields from the System ....................2 

Patient Setup.............................................................................................................................................................................................2 

Benefits of Option 1.................................................................................................................................................................................2 

Drawbacks of Option 1............................................................................................................................................................................2 

Option 2: Add a Prescription with Phases, Manually Record Treatments, then Treat Remaining Fields from the System...2 

Patient Setup.............................................................................................................................................................................................2 



Option 3: Add a Prescription for the Remaining Dose Only (cGy), Do Not Manually Record Treatments or Retrofit, then 

Only Treat Remaining Fractions from the System................................................................................................................................2 

Patient Setup.............................................................................................................................................................................................2 

Benefit of Option 3...................................................................................................................................................................................2 


ii Copyright 2009, IMPAC Medical Systems 

LTGRAD0005C/1.0/31-Mar-2009


Option 4: Add a Prescription for the Entire Dose (cGy) and Deliver Manually Recorded Treatments for All Fractions.....2 

Patient Setup.............................................................................................................................................................................................2 


Drawback of Option 4..............................................................................................................................................................................2 

Appendix B Dose Calculation .................................................................................................................2 

Definitions....................................................................................................................................................................................................2 

Calculation ...................................................................................................................................................................................................2 

Course Evaluation: Dosimetrist/Physicist Module III.....................................................................................2 

Copyright 2009, IMPAC Medical Systems iii 

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iv Copyright 2009, IMPAC Medical Systems 

LTGRAD0005C/1.0/31-Mar-2009


Copyright 2009, IMPAC Medical Systems 1 

LTGRAD0005C/1.0/31-Mar-2009 

Introduction 

Welcome to MOSAIQ Dosimetrist/Physicist Training Module III. This book is your 

guide to unlocking the possibilities of MOSAIQ 1.60 application software, hereafter 

referred to as MOSAIQ. It is designed to be used during your instructor-led training, 

and as a handy desk reference any time you need a quick reminder how to do 

something in MOSAIQ. We recommend that you keep this book near your 

workstation so you can find it easily when needed. 

This training guide is not intended to replace the MOSAIQ radiation oncology 

documentation, which is contained in the MOSAIQ Help system. The MOSAIQ 

Help system provides in-depth information on all available MOSAIQ features. 

Dosimetrist/Physicist Training Module III is an Intermediate course that, with 

Dosimetrist/Physicist Training Modules I and II, covers how to use MOSAIQ to review 

and add treatment information that your facility will use to safely treat the patient. This 

course assumes that you have basic Windows skills and have taken, and are familiar 

with, the concepts presented in MOSAIQ General Introduction training. Topics 

presented in this course build upon the concepts learned in the General Introduction. 

What’s In This Course 

In this course, you will review treatment information, define prescriptions, define 

treatment fields, change MLC files, import and export RTP files, review IMRT 

options, and set up dose tracking. You will also manually record treatments, change 

dose, use the Treatment Calendar, and run the eCHART Chart Check. 

In this module, you will use the Treatment Calendar to schedule treatment sessions 

and use eCHART Chart Check. 

This module also has two appendices that cover dose retrofitting options and dose 

calculations. 

This course will not teach you the basics of using MOSAIQ, which are covered in the 

General Introduction. 

Note that when you are working in the practice database, all activities are enabled for 

the practice ID. In your clinical database, you may or may not have security rights to 

do all the activities that you will do in this course.


Notes 

SupportPlus Online 

SupportPlus is IMPAC’s dedicated online support system, which gives you the most 

from your IMPAC oncology management system. SupportPlus contains valuable 

support information including installation and troubleshooting documents, training 

manuals, upgrade checklists, downloadable software tools, and much more. 

Access may be restricted based on your IMPAC service 

agreement. 

You can find this document under the Oncology Management tab in the Training 

Resources folder. 

Turn to SupportPlus for resources on implementation, training, support, and 

upgrades for all IMPAC products. 

For more information, contact support@impac.com, or call 800.488.4672. 

Log in to SupportPlus every week or two to check for new 

announcements, new document postings, and new training events. 

Please take a moment to send us a Product Suggestion. 

2 Copyright 2009, IMPAC Medical Systems 

LTGRAD0005C/1.0/31-Mar-2009

Introduction 


LTGRAD0005C/1.0/31-Mar-2009 

Notes 

Document Conventions 

This document uses specific conventions, or rules, in the instructions to help you 

perform the exercises correctly. This section explains the text, mouse, and keyboard 

conventions used in this document. 

Text Conventions 

The instructions in this guide are formatted to make them easy to read and to 

recognize when you should perform a particular task. The following text conventions 

are used in the instructions: 

Bold Print Indicates menu or list items that you select. 

Example: Click File | Register New Patient…. 

Example: In the Select Patient window, click Lamb, Mary. 

Italics Indicates words or phrases that appear on the computer 

screen, references to text or a number as itself, or new terms 

that are being defined. 

Highlighted 

Print 

Explanation 

s 

Example: Position the insertion point to the left of p in 

patient. 

Example: Annotation is the process of adding customized 

notes to a Help topic. 

Indicates something you type. 

Example: Type 3000. 

Located directly below the step. 

Menus Menu commands that are executed one directly after the 

other are separated by a vertical line. 

Buttons and 

Icons 

Example: Click File | System Utilities | Supplies… 

means from the menu bar, click File, from the 

File menu, point to the System Utilities 

command, and from the System Utilities menu, 

click the Supplies… command. 

Indicate items on which you click. 

Example: Click . 

Example: Click .


Notes 

Notes, 

Hints, and 

Warnings 

Note example: 

Hint example: 

Warning example: 

Mouse Conventions 

Notes, hints and warnings are preceded by unique symbols 

and are presented in a shaded box. Notes provide ancillary 

information, hints provide tips to help you use the system, 

and warnings provide important information on the 

consequences of performing a particular action. 

You can also open the eCHART Navigator window by pressing F5. 

You may find it helpful to print out illustrations from the Help 

reference tools to include with patient education materials. 

Once you change the status of an order to Voided, you cannot 

change the status again. 

The following terms are used to describe actions you perform with the mouse: 

Click Press and release the left mouse button. 

Double-click Click the left mouse button twice in rapid succession. 

Right-click Press and release the right mouse button. 

Drag Move the mouse while holding down the left mouse button. 

Highlight Drag the mouse pointer across data, causing the information 

to appear in reverse video. 


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Introduction 


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Notes Keyboard Conventions 

Keys that do not produce a character appear in all upper case bold print. These keys 

include: 

Function 

Keys 

F1, F2, F3, F4, F5, F6, F7, F8, F9, F10, F11, and F12. 

Booster Keys ALT, CTRL, and SHIFT. 

Pointer 

Movement 

Keys 

HOME, PAGE UP, PAGE DOWN, END, TAB, and the 

arrow keys. 

Other Keys BACKSPACE, DELETE, INSERT, CAPS LOCK, 

ESC, ENTER, SPACEBAR, PRINT SCRN, SCROLL 

LOCK, PAUSE, and NUM LOCK. 

Two or more keys that should be pressed simultaneously are separated by a plus sign. 

Example: Press CTRL+F4. 

Example: Press ALT+N.


Notes 


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Lesson 9 Treatment 

Calendar 

Objectives 

You will learn how to: 

• Schedule treatment sessions for single prescriptions, multiple prescriptions, single 

prescriptions with alternating patterns, ad hoc treatment sessions, and overlapping 

prescriptions 

• Remove treatment sessions 

• Add and remove treatment fields to an established Treatment Calendar 

• Remove and replace treatment fields 

• Change the sequence of treatment fields 

• Add and remove individual portal images 

• Add a series of portal images to treatment sessions 

• Change treatment session dates for single and multiple treatment sessions 

• Make ad hoc treatment session date changes 

• Move treatment sessions to the end of the calendar 

• Approve treatment sessions 

• Close incomplete sessions and schedule sessions with incomplete information 

• Define field groups before scheduling treatment sessions 

• Schedule AFS and MFS treatment sessions 

• Schedule QA mode treatment sessions 

The Treatment Calendar lets you add treatment sessions so your therapists can see 

which fields to treat on which days, and when to take portal images. It also lets you 

do more than just schedule and treat. You can use it to better track treatments – 

doses, portal images, and more. You can easily assign multiple prescription treatments 

or single prescriptions with alternating field patterns, and schedule portal images as 

necessary. 

In this lesson, you will learn how to schedule and manage treatment sessions for single 

or multiple prescriptions, no prescriptions, prescriptions with variable fractionation, or 

alternating pattern prescriptions. In addition, you will learn how to manage treatment 

fields and portal images.


Notes 

To open the Treatment Chart/Treatment Calendar window or 

Treatment Calendar Sessions dialog box, you must have Clinical | 

Care Plan | View security rights. 

To add, change, or remove treatment sessions from the Treatment 

Calendar, you must have Clinical | Care Plan | Modify rights. 

To approve a treatment session, you must also have Clinical | 

Care Plans | Approve rights. 

To add a QA mode treatment session, you must have Clinical | 

QA/Calibration | Modify rights. 

There are training videos for the Treatment Calendar and more 

documentation on the IMPAC SupportPlus website. 

Adding Treatment Sessions for a Single 

Prescription 

Single prescription treatment sessions are the simplest of sessions to add and schedule. 

In this exercise, you will add treatment sessions for a single radiation prescription. 

1. Open the chart for your lesson patient. 

2. Click eChart | Diagnoses and Interventions…, then click Course: 1. 

Opens the Diagnoses and Interventions window, then selects the course for 

which to create a Treatment Calendar. 

3. Right-click or press F4 in the Diagnoses and Interventions window, then click 

Treatment Calendar…. 

You can also click , then click . 

Opens the Treatment Calendar view of the Treatment Chart window, shown in 

Figure 1. 


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Lesson 9: Treatment Calendar 


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Notes 

Figure 1: Treatment Calendar View of the Treatment Chart Window 

The Treatment Chart window has 2 views: Treatment Calendar and Treatment 

Chart. Use the Treatment Calendar to plan radiation therapy treatments. Use the 

Treatment Chart to view historic and planned treatments and start treatment 

delivery or QA mode sessions. 

The Insert Sessions tab lets you add new sessions and appears if there are no 

planned treatment sessions for the patient. You can schedule the sessions with the 

prescribed fractionation for the patient or use the Wave Setup Form dialog box. 

The Insert Sessions tab contains the fields and information shown below: 

For Course n 

Prescription( 

s) 

Specifies a prescription site from the field to the right of 

the radio button. Treatment sessions use the number of 

fractions and the temporal pattern of fractions prescribed 

for the selected prescription site. n is the name or number 

of the course of treatment. 

Start Date Specifies a start date for the session. 

Other Specifies that you do not want to use a radiation 

prescription for the treatment sessions. You can click 

to 

add a single session, or click to add the number 

and pattern for a set of treatment sessions.


Notes Assign Fields 

Defined on 

“Schedule 

Fields” to 

each 

Inserted 

Session 

Insert 

Sessions For 

Course n 

Schedule 

Multiple Field 

Sets >> 

Schedule All 

Fields >> 

Lets you add a simple treatment plan when all sessions 

include the same fields. The checkbox is enabled if you 

added a set of fields to schedule in the Schedule Fields tab. If 

clicked, MOSAIQ assigns those fields to each new session 

when you add it. 

Opens the Wave Setup Form dialog box, from which you 

can add an ad hoc temporal fractionation pattern. 

Schedules the new treatment sessions and shows the new 

session(s) in the Calendar view. It adds the new session(s) to 

the list of historic and planned treatment sessions in the 

lower pane of the Treatment Calendar/Treatment Chart 

window. 

Schedules 1 set of fields in some of the newly added 

sessions, and a different set of fields in any of the other 

newly added sessions. 

Schedules the same set of fields in all newly added sessions. 

4. Click adjacent to the For Course 1 Prescription(s) field. 

If you select another care plan, such as Course 3, the radio button 

adjacent to the field changes to For Course 3 Prescription(s). 

Opens the Prescription list for all prescriptions in the course, shown in Figure 2. 

5. Click Lung. 

Figure 2: Prescription List 

Specifies the Lung prescription. The details of the prescription, such as technique, 

modality, and dose appear below the radio buttons. 

6. Click adjacent to the Start Date field. 

Opens the Calendar dialog box. The field defaults to the current date if it is a 

weekday. 

7. Click the date on which to start the sessions, then press ENTER. 

Specifies the date of the first treatment session. 

8. Click . 


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LTGRAD0005C/1.0/31-Mar-2009 

Notes Opens the Results of Insert Sessions message box, shown in Figure 3.


Notes 

9. Click . 

Figure 3: Results of Insert Sessions Message Box 

Schedules the new treatment sessions and shows the new sessions in the Calendar 

view. It also adds the new sessions to the list of historic and planned treatment 

sessions in the lower pane of the Treatment Calendar, shown in Figure 4. 

Inserted sessions in Calendar view. 

Added sessions. Dose Tracking Site. 

Figure 4: Treatment Calendar with Sessions Added 

The dose tracking sites appear in the far right. If you scroll to the right, the dose 

for the Rx: Lung tracking site appears in red. It appears in red because you have 

not scheduled the treatment fields. This is also why 0Flds appears in the ID 

column. 

10. Click . 

Opens the Fields To Be Scheduled dialog box, shown in Figure 5. 


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Notes 

Figure 5: Fields To Be Scheduled Dialog Box 

The Fields To Be Scheduled dialog box shows all radiation prescriptions and their 

treatment fields associated with the course you selected. 

11. Click the Lung prescription, then click . 

Adds the treatment fields to the Fields to be Scheduled pane to the right of the 

Available Course Fields pane, shown in Figure 6. 

Figure 6: Fields To Be Scheduled with Fields Selected 

You can also select each field individually, then click . 

12. Click . 

Closes the Fields To Be Scheduled dialog box, then goes back to the Treatment 

Calendar, shown in Figure 7.


Notes 

Figure 7: Treatment Calendar with Fields Selected 

The Schedule Fields tab is enabled and shows the fields you selected. The Schedule 

Fields tab lets you add a set and sequence of fields to schedule in the selected 

session(s). If you have not added the field sets when you click this tab, the Fields 

To Be Scheduled dialog box opens. The Schedule Fields tab contains the 

information and components below: 

ID Shows the treatment field ID number. 

Name Shows the treatment field name. 

Desc Shows the energy and modality of the treatment field. 

Dose Shows the field dose. 

Seq Shows AFS for Automatic Field Sequencing or MFS for 

Manual Field Sequencing as added in the Fields To Be 

Scheduled dialog box. If you have not defined the field 

sequencing, this column is blank. 

Opens the Fields To Be Scheduled dialog box, from 

which you can add the set of fields to schedule. 

Changes the sequence of the selected treatment field. Use 

the buttons to move the treatment field up or down the 

list. 

Removes all the treatment fields from the Fields To Be 

Scheduled pane. 


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Notes 

13. Click . 

Opens the Insert Sessions tab, from which you can add 

sessions for the subsequent prescription (if any). You can 

also click the Insert Sessions tab. 

Opens the Select Sessions tab, from which you can select 

the subsequent set of sessions (if any) for which to assign 

fields. You can also click the Select Sessions tab. 

Schedules the treatment fields for the selected session(s). 

After fields are scheduled, they disappear from the Fields 

To Be Scheduled pane. 

Adds the fields to the treatment sessions as shown in Figure 8. 

Figure 8: Treatment Calendar with Fields Added 

The ID columns shows 2 fields as part of each session, and the dose tracking site 

Rx: Lung shows the dose in blue rather than red. D appears in the Notes column 

for the 03/03/09 session and shows that a Dose Action Point is due.


Notes 

Removing Treatment Sessions from the 

Treatment Calendar 

If you make a mistake when you add a Treatment Calendar or schedule unnecessary 

treatment sessions, you can remove treatment sessions and the fields within them. 

Also, as you go through the exercises in this lesson, you will have to remove treatment 

sessions from a previous exercise. In this exercise, you will remove treatment fields 

and treatment sessions. 

You cannot remove already treated or incomplete sessions. You 

also cannot remove a session if it is approved or in QA mode. 

Refer to Closing an Incomplete Calendar Session in this lesson 

for more information on how to close an incomplete session. 

1. In the Treatment Calendar, click , then click . 

Opens the Select Sessions tab of the Treatment Calendar, then selects all sessions in 

the Treatment Calendar, shown in Figure 9. 

Figure 9: Treatment Calendar with Sessions Selected for Removal 

2. Click . 

Opens the Confirm Delete Sessions message box, shown in Figure 10. 

3. Click . 

Figure 10: Confirm Delete Sessions Message Box 

Removes the selected treatment sessions, closes the Confirm Delete Sessions 

message box, then opens the Information message box, shown in Figure 11. 


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Notes 

4. Click . 

Figure 11: Information Message Box 

Closes the Information message box, then goes back to the Treatment Calendar, 

shown in Figure 12. 

Figure 12: Treatment Calendar with Treatment Sessions Removed 

5. Click , then click . 

Refreshes the Treatment Calendar, then opens the Insert Sessions tab.


Notes 

Scheduling Treatment Sessions for Multiple 

Prescriptions 

Patients often have more than 1 radiation prescription site. For example, a patient can 

have a primary radiation site and a boost or cone down prescription site that comes 

after the primary prescription site. In this exercise, you will schedule treatment sessions 

for 2 prescriptions. 

1. In the Treatment Calendar, click . 

Opens the Insert Sessions tab for the Treatment Calendar. 

2. Click For Course 1 Prescription(s) if it is not already selected. 

Specifies that you want to create treatment sessions for Course 1. 

3. Click All from the For Course 1 Prescriptions field. 

Specifies that you want to schedule treatments for all prescription sites associated 

with the course, in this case, Lung and Lung Boost. Keep the Start Date field at its 

default or the current date – and the date on which you want to start treatment 

for this prescription. 

4. Click . 

Opens the Results of Insert Sessions message box for the Lung prescription site, 


Figure 13: Results of Insert Sessions Message Box – Continue with New Site 

5. Click . 

Closes the first Results of Insert Sessions message box, then opens the second 

Results of Insert Sessions message box for Lung Boost. 

6. Click . 

Closes the Results Insert Sessions message box for Lung Boost, then adds the 

treatment sessions for both prescription sites to the Treatment Calendar. 

7. Click . 

Opens the Select Sessions tab of the Treatment Calendar, shown in Figure 14. 


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Notes 

Figure 14: Treatment Sessions Added for Multiple Prescription Sites 

The Select Sessions tab lets you select all or a subset of the planned sessions. It 

appears first if there are any planned treatment sessions for the patient. When you 

select your sessions, you can schedule/change fields, change/remove sessions, 

schedule/change portal images, or change the status of sessions. The Select Sessions 

tab contains the information and components shown below: 

Prescriptio 

n 

Selects all planned sessions for the prescription site selected 

from the list to the right. 

Field Selects all planned sessions with the Field ID selected from 

the list to the right. 

Range Selects a range of planned sessions based on the first (From 

field) session number to the last (To field) session number. 

For example, type 3 in the From field and 8 in the To field to 

select planned sessions 3 through 8. 

Repeating Selects all planned sessions from a repeating pattern that uses 

the values of the On and Off fields. For example, type 1 in 

the On field and 2 in Off field to select every third planned 

session. 

Days Identifies the specific day(s) of the week on which to select 

planned sessions scheduled for those days. 

Invert Selects all planned sessions that do not meet the selected 

criteria. For example, if you selected planned sessions 1 

through 8 with the Range field, planned sessions 9 through n 

are selected when you click the Invert checkbox.


Notes Selects all of the planned sessions for the patient. 

Schedule 

Fields To Be 

Treated in 

These 

Sessions >> 

Clears the criteria selected (and any selected sessions). 

Opens the Fields To Be Scheduled dialog box, from which 

you can define the set of fields with which to schedule 

planned session(s). 

8. Click the Prescription checkbox, then click Lung from the Prescription field. 

Specifies the prescription for which to schedule the treatment fields and highlights 

the first 24 sessions in the Calendar view. 

9. Click . 

Opens the Fields To Be Scheduled dialog box. 

10. Click the Lung prescription site, then click . 

Adds the Lung treatment fields to the Fields to be Scheduled pane to the right of the 

Available Course Fields pane. 

11. Click . 

Closes the Fields To Be Scheduled dialog box, then opens the Treatment 

Calendar. The Schedule Fields tab is now active. 

12. Click . 

Schedules the treatment fields for the Lung prescription, shown in Figure 15. 

Figure 15: Treatment Calendar with First Prescription Scheduled 


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Notes 

13. Click . 

Opens the Select Sessions tab of the Treatment Calendar. Lung Boost is 

automatically selected in the Prescription list field. 

14. Repeat steps 8-12 for the Lung Boost prescription site. 

Schedules the treatment fields for the second prescription, shown in Figure 16. 

Figure 16: Treatment Calendar with Second Prescription Fields Scheduled 

Scheduling Treatment Sessions for a Single 

Prescription with an Alternating Pattern 

Patients can have a single prescription site with an alternating treatment field pattern. 

For example, 1 group of fields uses a bolus or wedge and 1 group of fields does not. 

In the following exercises, you will add treatment sessions for a single prescription 

with an alternating field pattern. 

1. In the Treatment Calendar, remove the treatment sessions you added in the 

previous exercise. 

Removes the treatment sessions that you scheduled in the previous exercise. You 

cannot remove treatment sessions that you already treated or approved. 

2. In the Diagnoses and Interventions window, add 2 new fields for the Lung 

prescription, 01B LT AP Lung w/Bolus and 02B LT PA Lung w/Bolus, 

shown in Figure 17.


Notes 

You can also add 2 fields for the Lung Boost prescription site: 

03W LAO Lung w/Wedge and 04W RPO Lung w/Wedge. 

Figure 17: Prescription with Alternating Treatment Fields 

3. In the Treatment Calendar, add treatment sessions for the prescription site to 

which you added the alternating fields. 

4. In the Insert Sessions tab, click . 

Opens the Select Sessions tab of the Treatment Calendar. 

5. Click the Repeating checkbox. 

Enables the On and Off fields. 

6. Type 1 in the On field, then type 1 in the Off field. 

Specifies to schedule treatment fields for every other treatment session, shown in 

Figure 18. 

Figure 18: First Set of Treatment Fields to Schedule Selected 


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Notes


Notes 7. Click . 


8. Add the treatment fields without the bolus (or wedge) to the Fields to be Scheduled 

pane, then click . 

Specifies which treatment fields to schedule, then closes the Fields To Be 

Scheduled dialog box. 

9. Click . 

Schedules the treatment fields, shown in Figure 19. 

Figure 19: Single Prescription with First Set of Alternating Fields Scheduled 

Every other treatment session has scheduled fields. 

10. Click . 


11. Click the Repeating checkbox, then click the Invert checkbox. 

Specifies to schedule the second set of alternating fields, shown in Figure 20. 


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Notes 

Figure 20: Second Set of Treatment Fields to Schedule Selected 

12. Click . 


13. Add the treatment fields with the bolus (or wedge) to the Fields to be Scheduled 

pane, then click . 

Specifies which treatment fields to schedule, then closes the Fields To Be 

Scheduled dialog box. 

14. Click . 

Schedules the treatment fields, shown in Figure 21.


Notes 

Figure 21: Single Prescription with Second Set of Alternating Fields 

Scheduling Ad Hoc BID Treatment Sessions 

You can schedule treatment fields for multiple prescriptions at the same time and you 

can also treat the same treatment fields more than once in a day. But, you cannot 

schedule a treatment field more than once in a treatment session. You can indicate in 

the radiation prescription itself that the treatment sessions take place twice each day. 

You can also use the Wave feature to schedule the same session more than once in a 

day or to add ad hoc treatment sessions. In this exercise, you will use the Wave feature 

to schedule ad hoc BID treatment sessions. 




cannot remove treatment sessions that you already treated or approved. 

2. In the Insert Sessions tab, click Other, then click . 

Specifies that you want to add ad hoc treatment sessions and opens the Wave 

Setup Form dialog box. 

3. Type the Start Date. 

Specifies when to start patient treatment. This field defaults to the current date. 

Keep After a certain number of times selected in the End group. 

4. In the End group, type 24 in the Times field. 

Specifies that you want to schedule 24 ad hoc treatment sessions. 


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Notes


Notes 5. In the Times Per Day group, click BID. 

Specifies to add the treatment session twice each day. The Interval field appears. 

6. Type 6 in the Interval field. 

Specifies to make the BID treatment sessions 6 hours apart. Keep the Pattern 

group with Daily selected as shown in Figure 22. 

Figure 22: Wave Setup Form with Ad Hoc BID Sessions Scheduled 

7. Click . 

Saves the change, closes the Wave Setup Form dialog box, then goes back to the 

Treatment Calendar. 

8. Click , then click 

. 

Opens the Results of Insert Sessions message box, adds the treatment sessions, 

then closes the Results of Insert Sessions message box. The Treatment Calendar 

shows the added sessions in Figure 23. 


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Notes 

Figure 23: Treatment Calendar with BID Sessions Added 

9. Click , click the treatment fields to schedule, then click 

. 

Opens the Fields To Be Schedule dialog box, then selects the treatment fields to 

schedule. Closes the Fields To Be Scheduled dialog box, then goes back to the 


10. In the Schedule Fields tab, click . 

Schedules the treatment fields, shown in Figure 24. 

Figure 24: Treatment Calendar with BID Treatment Fields Scheduled


Notes 

Scheduling Overlapping Treatment Sessions 

Overlapping or concomitant treatments involve overlapping treatment by different 

radiation prescriptions. For example, a secondary prescription, such as a cone down 

or boost, may overlap the primary radiation prescription by 5 or 10 days. In the 

following exercises, you will add treatment sessions, as well as schedule treatment 

fields for overlapping treatments. 

1. In the Radiation Prescriptions dialog box, change the site sequencing of the Lung 

Boost prescription so that it starts on fraction 19 of the Lung prescription. 

Changes the Lung Boost prescription so that it overlaps the Lung prescription. 

2. Open the Treatment Calendar, then remove the treatment sessions you added in 

the previous exercise. 


cannot remove treatment sessions that you have already treated or approved. 

3. Click , then click For Course 1 Prescription(s) if not already 

selected. 

Opens the Insert Sessions tab of the Treatment Calendar, then specifies that you 

want to create treatment sessions for Course 1. 

4. Click All from the For Course 1 Prescriptions field. 

Selects the prescription for which you want to add treatment sessions. 

5. Click , then click 

. 

Opens the Results of Insert Sessions message box, shown in Figure 25. 

Figure 25: Results of Insert Sessions for the Overlapping Treatments 

6. Click . 

Adds the sessions within the existing sessions, then closes the Results of Insert 

Sessions message box. 

7. Click . 



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Notes 8. Click the Prescription checkbox, then click Lung from the Prescription field. 

Selects the 24 sessions you just appended. 

9. Click . 


10. Add the Lung treatment fields to the Fields to be Scheduled pane, then click 

. 

Specifies the treatment fields to schedule, closes the Fields To Be Schedule dialog 

box, then goes back to the Treatment Calendar. 

11. In the Schedule Fields tab, click . 

Schedules the treatment fields for the Lung prescription. 

12. Click . 

Opens the Select Sessions tab with the Lung Boost prescription already selected in 

the Prescription field. 

13. Click the Prescriptions checkbox, then repeat steps 10-12 for the Lung Boost 

prescription. 

Schedules the treatment fields for the Lung Boost prescription, shown in 

Figure 26. 

Figure 26: Treatment Calendar with Scheduled Overlapping Sessions 

The treatment fields from the second prescription appear with the treatment 

fields of the first prescription.


Notes Working with Treatment Fields in the 


Not only can you schedule treatment sessions, and their associated treatment fields, 

but you can also manage treatment fields. In the following exercises, you will add 

treatment fields to an established Treatment Calendar, change the treatment order of 

the treatment fields, remove treatment fields from treatment sessions, replace 

treatment fields, as well as remove treatment fields. 

Adding a Treatment Field to an Established Treatment Calendar 

In this exercise, you will add treatment fields to treatments sessions in an established 


1. In the Treatment Calendar, click , then click . 

Opens the Select Sessions tab of the Treatment Calendar, then selects all treatment 

sessions in the Treatment Calendar. 

2. Click . 

Opens the Treatment Calendar Session dialog box. 

3. Click . 


4. Add the treatment fields with bolus (or wedge), then click . 


Calendar Session dialog box, shown in Figure 27. 

Figure 27: Treatment Calendar Session with Treatment Fields Added 


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Closes the Treatment Calendar Session dialog box, then opens the Confirm 

Selected Session Changes message box, shown in Figure 28. 

Figure 28: Confirm Selected Session Changes Message Box 

6. Click . 

Adds the treatment fields to the selected treatment sessions, then closes the 

Confirm Selected Session Changes message box. The treatment fields and 

sessions appear in the Treatment Calendar as shown in Figure 29. 

Figure 29: Treatment Calendar with Treatment Fields Added


Notes Changing the Treatment Order in the Treatment Calendar 

You can change the sequence of the treatment fields in the Treatment Calendar from 

the sequence in which they appear in Diagnoses and Interventions. This is useful if the 

sequence in which you added them is not the sequence in which you plan to treat the 

patient. In this exercise, you will change the sequence of the fields in the treatment 

sessions. 



2. Click . 

Specifies to select all treatment sessions. If you had a Treatment Calendar with 

multiple prescription sites, click the prescription from the Prescription field. 

3. Click . 


4. Click the treatment field whose sequence in the treatment sessions you want to 

change, then click or . Repeat as necessary. 

Changes the sequence of the treatment fields, shown in Figure 30. 

Figure 30: Treatment Calendar Session with Treatment Field Sequence 

Changed 

5. Click . 


Selected Session Changes message box. 

6. Click . 

Closes the Confirm Selected Session Changes message box. The changes to the 

treatment field sequence appear in the Treatment Calendar, shown in Figure 31. 


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Notes 

Figure 31: Treatment Calendar with Treatment Field Sequence Changed 

Removing a Treatment Field from the Treatment Calendar 

You can use the Remove Field… option to remove treatment fields rather than 

click for each individual treatment field. In this exercise, you will remove a 

treatment field from the Treatment Calendar. 

1. In the Treatment Calendar, click 1 of the treatment fields that you added in a 


Specifies the treatment field to remove. 

2. Right-click or press F4. 

Opens the Treatment Calendar Options menu, shown in Figure 32. 

3. Click Remove Field…. 

Figure 32: Treatment Calendar Options Menu 

Opens the Confirm Remove message box, shown in Figure 33.


Notes 

4. Click . 

Figure 33: Confirm Remove Message Box 

Removes the selected treatment field from all treatment sessions, then closes the 

Confirm Remove message box. The treatment field does not appear in the 

Treatment Calendar as shown in Figure 34. 

Figure 34: Treatment Calendar with Treatment Field Removed 

Replacing a Treatment Field in the Treatment Calendar 

You can also remove a treatment field and replace it with a different treatment field. 

In this exercise, you will replace a treatment field with a different treatment field. 

1. In the Treatment Calendar, click a treatment field that you added in a previous 

exercise. 

Specifies the treatment field to replace. 

2. Right-click or press F4, then click Replace Field…. 

Opens the Confirm Replace message box, shown in Figure 35. 

Figure 35: Confirm Replace Message Box 


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Notes



Closes the Confirm Replace message box, then opens the Treatment Field 

Definitions window, shown in Figure 36. 

Figure 36: Treatment Field Definitions Window 

4. Click the treatment field you removed in the previous exercise, then click 

. 

Replaces the treatment field you selected in step 1 with the treatment field you 

selected in step 4, then closes the Treatment Field Definitions window. The 

replaced field appears in the Treatment Calendar, shown in Figure 37. 

Figure 37: Treatment Calendar with Treatment Field Replaced 


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Notes Working with Portal Images 

The Treatment Calendar lets you schedule and change portal images for treatment at 

any time. You can schedule portal images before, during, or after treating the patient 

with the field. In the following exercises, you will add a portal image and a series of 

portal images to an existing Treatment Calendar. You will also add portal images 

when you add treatment sessions and fields for a patient, and remove portal images. 

Adding a Portal Image to an Established Treatment Calendar 

The Portal Image group lets you schedule portal imaging for the selected treatment 

field. You can select the checkboxes if portal imaging is scheduled for the selected 

treatment field. You can also change the portal imaging schedule. In this exercise, you 

will add an individual portal image to an established Treatment Calendar. 

1. In the Treatment Calendar, remove the treatment sessions you created in a 



cannot remove treatment sessions that you have already treated or approved. 

2. Schedule treatment sessions and treatment fields for the prescription site Lung. 

Schedules the treatment sessions to use for this exercise. 

3. Click adjacent to a treatment session. 

Shows the fields scheduled for the selected treatment session. 

The Portal Image group contains the fields and information below: 

Pre Schedules portal imaging before treatment of the selected 

treatment field. If clicked, Pre appears in the PI column of 

the Treatment Calendar. 

During Schedules portal imaging during treatment of the selected 

treatment field. If clicked, During appears in the PI column of 


Post Schedules portal imaging after treatment of the selected 

treatment field. If clicked, Post appears in the PI column of 


Only Schedules portal imaging only (no treatment) for the selected 

treatment field. If clicked, Only appears in the PI column of 


Adds a portal image-only instance of the selected treatment 

field. This lets you schedule a PI Only instance out of a field 

group sequence or multiple instances of imaging.


Notes 4. Click the first treatment field, then click During in the Portal Image group. 

Adds the portal image to the treatment session, shown in Figure 38. 

Figure 38: Treatment Calendar with Portal Image Added 

Removing a Portal Image 

You add or schedule portal images as you treat the patient. You can also remove 

them from 1, some, or all treatment sessions for a patient if the portal images are not 

necessary. In this exercise, you will remove a portal image from a treatment session. 

1. In the Treatment Calendar, click the treatment field to which you added the 

individual portal image in the previous exercise. 

Specifies the portal image to remove. The During checkbox in the Portal Image 

group to the right appears with a checkmark. 

2. Click the During checkbox so that it is not selected. 

Removes the portal image from the treatment session, shown in Figure 39. 


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Notes 

Figure 39: Treatment Calendar with Portal Image Removed 

Adding a Series of Portal Images to an Established Treatment 

Calendar 

You can also schedule or add a series of portal image exposures to treatment field(s) 

within a single treatment session or multiple treatment sessions. In this exercise, you 

will add multiple portal images to the Treatment Calendar. 



2. Click . 

Specifies to select all treatment sessions. Selects the Range checkbox, then fills in the 

From and To fields with the first and last treatment session numbers. 

3. Click . 

Opens the Treatment Calendar Session dialog box, shown in Figure 40.


Notes 

Figure 40: Treatment Calendar Session Dialog Box 

The Treatment Calendar Session dialog box lets you add treatment sessions and 

schedule or change treatment fields and portal imaging within sessions. You can 

also schedule QA Mode sessions to verify field accuracy before or during a 

course of therapy and add notes for the session(s). 

If you change multiple sessions, the Due Date Shift group is inactive. The number 

of sessions selected appears to the right of the Due Date Shift group. 

4. Click the second treatment field, then click Post in the Portal Image group. 

Specifies to take a portal image after you treat the patient with the selected 

treatment field. 

5. Click the first treatment field, then click Pre in the Portal Image group. 

Specifies to take a portal image before you treat the patient with the selected 

treatment field(s), shown in Figure 41. 

Figure 41: Treatment Calendar Session with Portal Images Selected 


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Selected Sessions Changes message box, shown in Figure 42. 

Figure 42: Confirm Selected Sessions Changes Message Box 

7. Click . 

Adds the portal image series to the treatment sessions, then closes the message 

box. The Treatment Calendar appears, shown in Figure 43. 

Figure 43: Treatment Calendar with Portal Image Series Added 

2PIs appears in the PI column at the session level because 2 portal images were 

scheduled for each treatment session. On the treatment field level, Pre and Post 

appear to identify the type of portal image. You can add portal images to any 

combination of treatment sessions with the Select Sessions tab.


Notes 

Changing Treatment Session Due Dates 

If a patient misses a treatment session or has a delay in treatment, you can change the 

treatment session dates. You can change the dates of all treatment sessions, change a 

single session, or move the affected treatment session to the end of the treatment. In 

the following exercises, you will change the date of all sessions, change a single session 

date, and move a treatment session to the end of treatment. 

Changing All Treatment Session Due Dates 

In this exercise, you will change the dates of all the treatment sessions. 

1. In the Treatment Calendar, click a treatment session, then click . 


2. Type the date 1 day after the treatment session you selected in the Due field. 

Changes the scheduled date of the treatment session. 

3. In the Due Date Shift group, click All sessions after this one. 

Specifies to shift all treatment sessions after the selected treatment session, shown 

in Figure 44. 

Figure 44: Treatment Calendar Session with All Session Dates Changed 

If you typed a date 3 days after the original treatment date, MOSAIQ 

automatically shifts all remaining appointments by the same number of days. The 

default number of shift days is the difference between the originally scheduled 

due date and the due date you typed. This can cause the shift you want, but 

weekends and holidays can have an affect on the new due dates. If the first 

session due date change spans a non-treatment day (for example, a weekend or 

holiday), the Preview Recommended message appears. 


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Opens the Treatment Calendar Shift Preview dialog box, shown in Figure 45. 

Figure 45: Treatment Calendar Shift Preview Dialog Box 

The Treatment Calendar Shift Preview dialog box lets you see what the treatment 

calendar looks like after you make a change. You can use the Shift after First field 

to change the number of days by which to shift the treatment sessions. You can 

use the First Session Date field in the Shifted group to change the date of the first 

session. Use the Selected Session Date field to change the date of a selected session. 

The Treatment Calendar Shift Preview dialog box contains the information and 

components below: 

Original Group 

First 

Session 

Date (*) 

Selected 

Session 

Date 

Calendar 

View 

Shows the original date of the session. 

Shows the original date of the session (cell) selected 

(highlighted) on the original calendar view. Blank if there is 

no session in the selected cell. 

Shows the original treatment session calendar. The columns 

for Week, Date, days of the week (Sunday through Saturday) 

have an X to show a scheduled treatment. The list has 1 row 

per week and 1 column per weekday. 1 row per daily 

session with a cell for each date appears for each week with 

multiple same-day sessions. An asterisk (*) appears adjacent 

to the due date of the session. An X appears adjacent to the 

session due date after the first one. An asterisk (*) appears 

adjacent to the week with the session due date.


Notes Shift after First Group 

Days Specifies the number of days to shift the treatment calendar 

session(s). This field is the same as the Days field in the Due 

Date Shift group of the Treatment Calendar Session dialog 

box. You can click to change the number of days, which 

automatically updates. Disabled for ad hoc shifts. 

Ad Hoc Specifies an ad hoc shift. This checkbox only appears for ad 

hoc shifts. MOSAIQ defines a shift as ad hoc when you 

change a shifted session due date manually with the Selected 

Session Date field or drag and drop the session in the Shifted 

group. You can de-select the checkbox to use the Days field. 

Incomplete Appears when a shift is not complete. This only appears if 

the shift is not ad hoc – and the Days value is 0 or negative 

and no sessions are shifted. This can appear if you specify a 

shift amount that would cause overlapping sessions (you shift 

a negative number of days past a session that precedes the 

first session you changed). 

No Shift Appears below the Days field if you did not specify a shift, 

or if a negative value appears in the Days field. This only 

shows if the shift is not ad hoc – and the Days value is 0 or 

negative and no sessions are shifted. This can appear if you 

specify a shift amount that would cause overlapping sessions 

(you shift a negative number of days past a session that 

precedes the first session you changed). 

Shifted Group 

First 

Session 

Date (*) 

Selected 

Session 

Date 

Calendar 

View 

5. Click . 

Specifies the Due date value from the Treatment Calendar 

Session dialog box. If the shift is not ad hoc, click to change 

the first session date value and automatically update the 

shifted session due dates in the Shifted group and the Selected 

Session Date field if a session is selected. 

Specifies the original date of the session (cell) selected 

(highlighted) on the original calendar. Blank if there is no 

session in the selected cell. You cannot make an entry that 

changes the session sequence. You also cannot make an entry 

that includes Sundays, Holidays, or Saturdays. 

Shows the treatment session calendar after you shifted the 

treatment sessions. 

Closes the Treatment Calendar Shift Preview dialog box. 


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Changes the treatment session due dates, then closes the Treatment Calendar Shift 

Preview and Treatment Calendar Session dialog boxes. The Treatment Calendar 

appears, shown in Figure 46. 

Figure 46: Treatment Calendar with All Session Dates Changed 

Making an Ad Hoc Treatment Session Date Change 

You can use the Days field in the Shift After First group to make an ad hoc change in 

the Treatment Calendar Shift Preview dialog box. In this exercise, you will make an 

ad hoc treatment session date change. 

1. In the Treatment Calendar, click a treatment session that occurs on a Friday, then 

click . 


2. Type the date for the upcoming Monday after the treatment session you selected 

in the Due field. 

Changes the scheduled date of the treatment session. 


Specifies to shift all treatment sessions after the selected one, shown in 

Figure 47.


Notes 

Figure 47: Treatment Calendar Session with Preview Recommended 

The message Preview Recommended appears to the right of the All sessions after this one 

radio button. 

4. Click . 

Opens the Treatment Calendar Shift Preview dialog box, shown in Figure 48. 

Figure 48: Treatment Calendar Shift Preview Dialog Box with Shift 

5. In the Shifted group, click the first of the treatment sessions that do not line up. 

Specifies the treatment session that you want to move. You can only do an ad 

hoc shift of treatment sessions in sequence, that is, one at a time. 

6. Use your mouse to drag the treatment session to the correct position. 

Moves the treatment session to its correct position. In the Shift After First group, 

the Days field is now disabled and the Ad Hoc checkbox appears, shown in 

Figure 49. If you click the Ad Hoc checkbox so that it is not selected, the 

Treatment Calendar Shift Preview dialog box shows the original Days. 


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Notes 

Figure 49: Treatment Calendar Shift Preview with Ad Hoc Change 

7. Move each treatment session until all are in the correct position, then click 

. 

Closes the Treatment Calendar Shift Preview dialog box. The Treatment 

Calendar Session dialog box shows the ad hoc change, shown in Figure 50. 

Figure 50: Treatment Calendar Session with Ad Hoc Change 

A new checkbox appears in the Treatment Calendar Session dialog box, Ad Hoc 

per Preview. The Due Date Shift of All sessions after this one Day(s) field is disabled. It is 

disabled because the ad hoc due date changes are not strictly a shift by a specific 

number of days. 

To clear your ad-hoc changes, click Ad Hoc per Preview so that it is not 

selected. Preview Recommended appears and the Day(s) field is enabled with the 

original number of shift days and your ad hoc changes are lost. 

8. Click .


Notes Changes the treatment session due dates, then closes the Treatment Calendar Shift 

Preview and Treatment Calendar Session dialog boxes. The Treatment Calendar 

appears. 


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Notes Changing a Single Treatment Session Due Date 

You can change an individual treatment sessions due date so that it does not impact 

or shift the due dates of other treatment sessions. For example, you can schedule a 

missed treatment to a Saturday or other non-treatment day so that it does not impact 

other treatment sessions. You can also move the treatment session to the end of 

treatment as in the next exercise. In this exercise, you will change the due date of a 

single session, but will not change the dates of any other sessions. 

1. In the Treatment Calendar, click the a treatment session, then click . 


2. In the Due field, type the first Saturday after the first treatment date. 

Specifies the new due date of the treatment session. 

3. In the Due Date Shift group, click No other sessions if it is not already 

selected. 

Specifies to change the date of the selected session only, shown in Figure 51. 

Figure 51: Treatment Calendar Session with Single Session Date Changed 

4. Click . 

Changes the treatment session due date, then closes the Treatment Calendar 

Session dialog box. The Treatment Calendar appears, shown in Figure 52.


Notes 

Figure 52: Treatment Calendar with Single Session Date Changed 

Moving a Treatment Session to the End of the Treatment 

Calendar 

You can move a missed treatment session to the end of the Treatment Calendar 

rather than move it to a Saturday or other non-treatment day. This is similar to the 

Add to End feature in the Wave Edit Form dialog box. In this exercise, you will 

move the treatment session to the end of the Treatment Calendar. 

For multiple prescriptions, the treatment session moves to the 

very end of the treatment sessions, not the end of the treatment 

sessions for the prescription. 

1. In the Treatment Calendar, click the treatment session you moved to Saturday, 

then click . 


2. In the Due Date Shift group, click Move this session to the end. 

Specifies to move selected treatment session to the end of the treatment sessions. 

The date in the Due field automatically changes, shown in Figure 53. 


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Notes 

Figure 53: Treatment Calendar Session with Session Moved to End 

3. Click . 

Changes the treatment session due date, then closes the Treatment Calendar 

Session dialog box. The change appears in the Treatment Calendar, shown in 

Figure 54. 

Figure 54: Treatment Calendar with Session Moved to End 

The Treatment Calendar automatically schedules around weekends if you move 

the date to the end of the treatment sessions. If your system administrator has 

added your holidays in MOSAIQ, the Treatment Calendar also automatically 

schedules around them.


Notes Working with Treatment Sessions from the 


You can do more than add sessions and schedule fields in the Treatment Calendar. In 

the following exercises, you will approve a treatment session, close an incomplete 

treatment session, and schedule a session with incomplete information. You will also 

define fields before you schedule a session, schedule an AFS session, schedule an MFS 

session, and schedule a QA mode treatment session. 

Approving a Treatment Session 

Some facilities require that you approve a treatment field before you can treat the 

patient. You can also configure MOSAIQ to require that you approve the treatment 

session before treatment to add another layer of security. In this exercise, you will 

approve a treatment session. 

1. In the Treatment Calendar, remove all existing treatment sessions, then add 

treatment sessions and schedule fields for the Lung prescription. 

Specifies the treatment session to approve. 

2. Select a treatment session, then click . 

Opens the Record Status dialog box. 

3. In the New Status group, click Approved. 

Specifies that you want to approve the treatment session. 

4. Type your Password, then click . 

Approves the treatment session, closes the Record Status dialog box, then goes 

back to the Treatment Calendar, shown in Figure 55. 

Figure 55: Treatment Calendar with Approved Treatment Session 


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Notes A appears in the Sts column to identify that the treatment session was approved. 

The ^ appears adjacent to the A to identify that this is the first treatment session. 

5. Click . 


6. Click Range. 

Specifies that you want to select a range of treatment sessions. 

7. Type 2 in the From field, then type 4 in the To field. 

Selects treatment sessions 2 through 4. The Calendar view highlights treatment 

sessions 2, 3, and 4. 

8. Click , then approve the sessions. 

Approves the selected treatment sessions, shown in Figure 56. 

Figure 56: Treatment Calendar Showing Multiple Sessions Approved 

You can select as many treatment sessions as necessary to approve at a time with 

the Select Sessions tab. To approve all sessions, click on the Select Sessions 

tab, then follow steps 2-4 in this exercise.


Notes Closing an Incomplete Calendar Session 

If you did not fully treat a patient for a particular session, you can close the 

incomplete session. Or, if you did not fully treat a field, you can close the session if 

you do not want to complete the treatment for that session. In this exercise, you will 

close out an incomplete calendar session. 

1. In the Treatment Chart window, click , then click a partially treated 


Specifies the treatment session to close out. 

2. Click . 

Opens the Record Status dialog box. 

3. In the New Status group, click Approved. 

Specifies that you want to approve the treatment session. You must first approve 

the treatment session before you can close it (change the status to Closed). 


Approves the treatment session. 

5. Click the treatment session you just approved, then click . 

Opens the Record Status dialog box. Some statuses were not available when the 

treatment session had a status of Pending. When you approve a treatment session, 

other statuses, such as Closed, are available. 

6. In the New Status group, click Closed. 

Specifies that the treatment session is Closed. 


Closes the treatment session, then closes the Record Status dialog box. The 

Treatment Chart window appears. 

8. Click . 

Closes the Treatment Chart window. 


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Notes Scheduling Treatment Sessions with Incomplete Information 

In some situations, you may need to add treatment sessions and schedule treatment 

fields when you have no radiation prescription, or you have a radiation prescription 

but no treatment fields. For example, the physician did not write the radiation 

prescription or wrote the radiation prescription but not the treatment fields. Or, the 

physician wrote 1 radiation prescription, but not the second boost/cone down 

radiation prescription. In this exercise, you will add treatment fields that are not 

associated with a prescription, then add treatment sessions. 

1. Open the Diagnoses and Interventions window, right-click or press F4, then click 

Add Tx Field without Rad Rx…. 

Opens the Treatment Field Definition dialog box. Use the Add Tx Field without 

Rad Rx option when you have field information, but no radiation prescription 

and you must schedule treatment sessions. 

2. In the Treatment Field Definition dialog box, add field information for the new 


Shows the new treatment fields separate from the diagnosis and radiation 

prescriptions that already appear in the Diagnoses and Intervention window, 


Figure 57: Diagnoses and Interventions with Treatment Field Not Associated 

with a Prescription


Notes 3. Click , then click . 

Opens the Treatment Calendar. 

4. Remove the existing treatment sessions in the Treatment Calendar. Void the 

approved treatment sessions. 

Removes all treatment sessions so that you can schedule the new treatment fields. 

5. Click , click Other, then click . 

Opens the Wave Setup Form dialog box. 


Specifies that you want to add 15 treatment sessions in the Treatment Calendar. 

Keep the Times Per Day group set to Once, and the Pattern group set to Daily. 

7. Click . 

Closes the Wave Setup Form dialog box, then opens the Treatment Calendar. 

8. Click . 

Opens the Results of Inserts Sessions message box. 

9. Click . 

Closes the Results Insert Sessions message box, then adds the treatment sessions in 

the Treatment Calendar as shown in Figure 58. 

Figure 58: Treatment Sessions with No Radiation Prescription 


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Notes Dose tracking columns appear in Figure 58, but they do not appear if you had 

actually added treatment sessions for a patient with no radiation prescription. 

Adding a Field Group First When Scheduling Treatment Sessions 

You can define the field group, then schedule the treatment fields and treatment 

sessions. In this exercise, you will add the treatment fields and the field group to 

schedule before you add the treatment sessions. 



Clears the Treatment Calendar of all treatment sessions. You cannot remove 

treatment sessions that you have already treated, approved, or changed to QA 

mode sessions. 

2. Click . 


3. Right-click or press F4, then click Show Treatment Fields for All 

Courses. 

Opens the treatment fields that are not associated with a prescription, shown in 

Figure 59. 

Figure 59: Fields To Be Scheduled with Field Group 

4. Add the 3 LAO Lung and 4 RPO Lung treatment fields to the field group in 

the Fields to be Scheduled pane. 

Specifies the fields that comprise the field group. 

5. Click . 

Closes the Fields To Be Scheduled dialog box, then shows the Treatment 

Calendar. 

6. Click . 

Treatment field not associated with a prescription 

Opens the Insert Sessions tab, shown in Figure 60.


Notes 

Figure 60: Insert Sessions Tab with Field Group Checkbox Active 

The Assign Fields Defined on “Schedule Fields” to each Inserted Session checkbox is active. 

7. Click Assign Fields Defined on “Schedule Fields” to each 

Inserted Session. 

Specifies to schedule the field group in each added treatment session. 

8. Click Other, then click . 

Opens the Wave Setup Form dialog box. 

9. Type the start date in the Date field. 

Specifies the day on which you want the added treatment sessions to start. The 

field defaults to the current date. 


Specifies that you want to add 15 sessions in the Treatment Calendar. Keep the 

Times Per Day group set to Once, and the Pattern group set to Daily. 

11. Click . 

Closes the Wave Setup Form dialog box, then shows the Treatment Calendar. 

12. Click . 

Opens the Results of Inserts Sessions message box. 

13. Click . 

Closes the Results Insert Sessions message box, then adds the treatment sessions 

for your defined field group. 


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Notes Scheduling AFS Treatment Sessions 

In previous exercises, you used the Fields To Be Scheduled dialog box to identify the 

treatment fields to include in treatment sessions. You can also schedule Automatic 

Field Sequencing (AFS) or Manual Field Sequencing (MFS) for a treatment session or 

specific field(s) within the selected treatment session. AFS automatically brings the 

subsequent treatment field up during the treatment session, and records all fields after 

treatment. In this exercise, you will add AFS treatment sessions and schedule treatment 

fields. 

1. In the Treatment Calendar, remove existing treatment sessions from the previous 

exercise, then add sessions for the Lung prescription. 

Clears the Treatment Calendar of all treatment sessions, then adds sessions for the 

Lung prescription. 

2. Click . 


3. Click in the Available Course Fields pane, then click . 

Adds Automatic Field Sequencing to the Fields To Be Scheduled pane to the right, 


Figure 61: Fields To Be Scheduled with AFS Added 

If the fields are out of sequence or not added between AFS Begin 

and AFS End, use the up/down arrow buttons. You can also add or 

remove fields, move fields, and change the sequence of the fields. 

4. Add 2 treatment fields to the Fields to be Scheduled pane. 

Specifies the treatment fields to include in the AFS group, shown in Figure 62.


Notes 

5. Click . 

Figure 62: Fields To Be Scheduled with AFS Configured 

Closes the Fields To Be Scheduled dialog box, then shows the Treatment 

Calendar. 

6. Click . 

Schedules the fields, shown in Figure 63. 

Figure 63: Treatment Calendar with AFS Treatment Sessions 

AFS Beg appears in the Seq column to identify the start of the AFS session. AFS 

appears below it in the Seq column to identify the end of the AFS session. 


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Notes Scheduling MFS Treatment Sessions 

MFS or Manual Field Sequencing automatically brings the next treatment field up 

during the treatment session like AFS. Unlike AFS, you must record the treatment 

before you can treat the subsequent field. In this exercise, you will add MFS treatment 

sessions and schedule treatment fields. 

1. In the Treatment Calendar, remove existing treatment sessions from the previous 

exercise, then add treatment sessions for the prescription Lung. 

Clears the Treatment Calendar of all treatment sessions, then adds sessions for the 

Lung prescription. 

2. Click . 



Adds Manual Field Sequencing to the Fields To Be Scheduled pane, shown in 

Figure 64. 

Figure 64: Fields To Be Scheduled with MFS Added 

4. Add two treatment fields to the Fields to be Scheduled pane. 

Specifies the treatment fields to include in the MFS group, shown in Figure 65. 

5. Click . 

Figure 65: Fields To Be Scheduled with MFS Configured 


Calendar. MFS appears in the Seq column of the Schedule Fields tab.


Notes 


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Schedules the fields, shown in Figure 66. 

Figure 66: Treatment Calendar with MFS Treatment Sessions 

MFS Beg appears in the Seq column to identify the start of the MFS session. MFS 

appears in the Seq column to identify the end of the MFS session. 

Scheduling a QA Mode Treatment Session 

QA Mode lets you run a quality check on a treatment field without a contribution to 

dose or fractions in the patient chart. QA mode recordings do not affect field 

fraction counts, field dose, dose site fractions, dose, or elapsed days. When you treat a 

QA mode treatment session from the Treatment Chart, a warning message tells you 

that QA mode treatments do not contribute to patient dose tracking. You can 

schedule QA mode sessions from the Treatment Calendar or the Treatment Chart. In 

this exercise, you will schedule a QA mode treatment session via the Treatment 

Calendar. 

You can now assign access rights to QA Mode distinct from 

Treatment Delivery security rights. 

1. In the Treatment Calendar, remove the treatment sessions, add treatment sessions 

for the Lung prescription, then schedule the fields for the prescription. 

Clears the Treatment Calendar of all treatment sessions, then adds the treatment 

sessions and schedules the fields to use in this exercise. 

2. Double-click a treatment session. 

Specifies the treatment session you want to schedule as a QA mode treatment 

session, then opens the Treatment Calendar Session dialog box. 

3. Right-click or press F4.


Notes Opens the Treatment Calendar Session Options menu, shown in Figure 67. 


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Notes 

4. Click QA Mode. 

Figure 67: Treatment Calendar Session Options Menu 

Specifies that this is a QA mode treatment session, shown in Figure 68. 

Figure 68: Treatment Calendar Session with QA Mode Session 

QA Mode appears to the right of the Status field. 

5. Click . 

Changes the session to QA mode, then closes the Treatment Calendar Session 

dialog box. The Treatment Calendar appears, shown in Figure 69. 

Figure 69: Treatment Calendar with QA Mode Session


Notes QA appears in the Fx column. 

6. Change the treatment field back to its original state. 

What's Next 

In this lesson, you learned how to schedule treatment sessions for single prescriptions, 

single prescriptions with alternating patterns, ad hoc treatment sessions, and 

overlapping treatment prescriptions. You learned how to change treatment field 

sequence, add or remove individual treatment fields, and remove or replace treatment 

fields. You learned how to change treatment session dates, add or remove portal 

images, move individual treatment sessions to the end of the Treatment Calendar, and 

approve treatment sessions. Finally, you learned how to close incomplete sessions, 

schedule treatment sessions with incomplete information, define field groups, schedule 

AFS/MFS treatment sessions, and schedule QA mode treatment sessions. Use the 

Quick Version as a concise, step-by-step guide when you must quickly apply any of 

the skills you have learned in this lesson or if you simply want to reinforce what you 

have learned. 

In the next lesson, you will learn how to change prescribed total doses, prescribed 

fractional doses, and MU/dose coefficients. 


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Notes Quick Version 

Scheduling Treatment Sessions for a Single Prescription 

1. Click , then click to open the Treatment Calendar. 

2. In the Insert Sessions tab, click For Course n Prescription(s) if it is not 

already selected. 

3. Click the prescription site for which you want to schedule sessions in the For 

Course n Prescription(s) field. 

4. Type the date on which you want treatment to start in the Start Date field. 

5. Click . 

6. In the Results of Insert Sessions message box, click . 

7. In the Insert Sessions tab of the Treatment Calendar, click 

. 

8. In the Fields To Be Scheduled dialog box, click the prescription site or individual 

treatment field(s), then click . 

9. Click . 

10. In the Schedule Fields tab of the Treatment Calendar, click . 

Scheduling Treatment Sessions for Multiple Prescriptions 


2. Click For Course n Prescription(s) if it is not already selected. 

3. Click All in the For Course n Prescription(s) field. 


5. Click . 

6. In the Results of Insert Sessions message box, click , then click 

. 


. 

8. In the Select Sessions tab, click Prescription, then click the prescription site from 

the Prescription field. 

9. Click .


Notes 10. In the Fields To Be Scheduled dialog box, click the prescription site or treatment 

fields, then click . 

11. Click . 


13. Click . 

14. Repeat steps 8-12 for the each prescription site. 

Scheduling Treatment Sessions for a Single Prescription with an 

Alternating Pattern 

1. In the Treatment Calendar, add treatment sessions for the prescription site. 

2. In the Insert Sessions tab, click . 

3. In the Select Sessions tab, click Repeating. 

4. Type the number of treatment fields that comprise the ON pattern in the On 

field. 

5. Type the number of treatment fields that comprise the OFF pattern in the Off 

field. 

6. Click . 

7. In the Fields To Be Scheduled dialog box, add the treatment fields for the ON 

pattern to the Fields to be Scheduled pane, then click . 


9. Click . 

10. In the Select Sessions tab of the Treatment Calendar, click Repeating, then click 

Invert. 

11. Click . 

12. In the Fields To Be Scheduled dialog box, add the treatment fields for the OFF 

pattern to the Fields to be Scheduled pane, then click . 



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Notes Scheduling Ad Hoc Treatment Sessions 


2. In the Insert Sessions tab, click For Course n Prescription(s) if it is not 




4. Click Other, then click to open the Wave Setup Form dialog box. 

5. Type or select the start date of treatments in the Date field. 

6. In the End group, identify how many sessions you want scheduled. 

7. In the Times Per Day group, click BID. 

8. Type the Interval between treatments in hours. 

9. In the Pattern group, select the pattern or keep Daily selected. 

10. Click to close the Wave Setup Form dialog box. 


. 

12. In the Results of Insert Sessions message box, click . 


. 

14. In the Fields To Be Scheduled dialog box, add the treatment fields you want to 

schedule, then click . 


Scheduling Treatment Sessions for Overlapping Treatments 

1. In the Treatment Calendar, add the treatment sessions for the first prescription 

site. 

2. Click , then click For Course n Prescription(s) if it is not 





5. Click . 

6. In the Results of Insert Sessions message box, click .


Notes 7. In the Insert Sessions tab of the Treatment Calendar, click 

. 

8. In the Select Sessions tab, click Prescription, then click the prescription site of 

the overlapping treatment. 

9. Click . 

10. In the Fields To Be Scheduled dialog box, add the overlapping treatment fields to 

the Fields to be Scheduled pane, then click . 


Adding a Treatment Field to an Established Treatment Calendar 

1. In the Treatment Calendar, click , then click 

session(s) to which you want to add the treatment field(s). 

2. Click . 

3. In the Treatment Calendar Session dialog box, click . 

to select the 

4. In the Fields To Be Scheduled dialog box, click the treatment field(s) you want to 

add to the treatment session(s), then click . 

5. Click . 

6. In the Treatment Calendar Session dialog box, click . 

7. In the Confirm Selected Session Changes message box, click . 

Changing the Treatment Order in the Treatment Calendar 


2. In the Select Sessions tab, click to select the treatment session(s) whose 

order you want to change. 

3. Click to open the Treatment Calendar Session dialog box. 

4. Click a treatment field, then click or to change the order of the 


5. Click . 

6. In the Confirm Selected Session Changes message box, click . 


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Notes Removing a Treatment Field in the Treatment Calendar 

1. In the Treatment Calendar, click the treatment field that you want to remove. 

2. Right-click or press F4 in the Treatment Calendar. 

3. In the Treatment Calendar Options menu, click Remove Field…. 

4. In the Confirm Remove message box, click . 


1. In the Treatment Calendar, click the treatment field that you want to replace with 

another treatment field. 

2. Right-click in the window or press F4, then click Replace Field…. 

3. In the Confirm Replace message box, click . 

4. In the Treatment Field Definitions window, click the treatment field with which 

you want to replace the other field. 

5. Click . 

Adding a Portal Image to an Established Treatment Calendar 

1. In the Treatment Calendar, click adjacent to the treatment session to which you 

want to add a portal image. 

2. Click the treatment field to which you want to add the portal image. 

3. To schedule a portal image during treatment, click a treatment field, then click 

During in the Portal Image group. 

4. To schedule a portal image after the field is treated, click a treatment field, then 

click Post in the Portal Image group. 

5. To change the scheduled treatment field to take a portal image only, click a 

treatment field, then click Only in the Portal Image group. 

Adding a Series of Portal Images to an Established Treatment 

Calendar 


2. In the Select Sessions tab, click to select the treatment sessions to which 

you want to add the portal image series. 

3. Click .


Notes 4. In the Treatment Calendar Session dialog box, click a treatment field, then click 

Pre in the Portal Image group to schedule a portal image before the field is 

treated. 

5. To schedule a portal image during treatment, click a treatment field, then click 

During in the Portal Image group. 

6. To schedule a portal image after the field is treated, click a treatment field, then 

click Post in the Portal Image group. 

7. To change the scheduled treatment field to take a portal image only, click a 

treatment field, then click Only in the Portal Image group. 

8. Click . 

9. In the Confirm Selected Sessions Changed message box, click . 

Removing a Portal Image 

1. In the Treatment Calendar, click adjacent to the treatment session that has a 

portal image that you want to remove. 

2. Click the treatment field with the portal image that you want to remove. 

3. Click the Portal Image group checkbox, such as During, so that it is not selected. 

Changing All Treatment Session Due Dates 

1. In the Treatment Calendar, click the first of the treatment sessions whose due date 

you want to change, then click . 

2. In the Treatment Calendar Session dialog box, type the new due date for the 

treatment session in the Due field. 


4. Type the number of days in the field adjacent to All sessions after this one. 

5. Click to open the Treatment Calendar Shift 

Preview dialog box. 

6. Use the Days field in the Shift after First group to change the shifted treatment 

sessions. 



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Notes Making an Ad Hoc Treatment Session Date Change 

1. In the Treatment Calendar, click a treatment session, then click to open 

the Treatment Calendar Session dialog box. 

2. Type the new date for the treatment session you selected in the Due field. 


4. Click to open the Treatment Calendar Shift 

Preview dialog box. 

5. In the Shifted group, click the first of the treatment sessions that do not line up. 

6. Use your mouse to drag the treatment session to the correct position. 

7. Move each treatment session until all are in the correct position. 

8. To remove the ad hoc changes, click the Ad Hoc checkbox so that it is not 

selected. 

9. Click to close the Treatment Calendar Shift Preview dialog box. 

10. Click to close the Treatment Calendar Session dialog box. 

Changing a Single Treatment Session Due Date 

1. In the Treatment Calendar, click the treatment session whose due date you want 

to change, then click . 

2. In the Treatment Calendar Session dialog box, type the new due date for the 

treatment session in the Due field. 

3. In the Due Date Shift group, click No other sessions if it is not already 

selected. 

4. Click . 


Calendar 

1. In the Treatment Calendar, click the treatment session that you want to move to 

the end. 

2. Click to open the Treatment Calendar Session dialog box. 

3. In the Due Date Shift group, click Move this session to the end. 

4. Click .


Notes Approving a Treatment Session 

1. In the Treatment Calendar, click the treatment session that you want to approve, 

then click . 

2. In the New Status group of the Record Status dialog box, click Approved. 

3. Type your Password field, then click . 

4. Click . 

5. To approve all sessions, click , then repeat steps 2-4. 

6. To approve a specific group of sessions, click the Range checkbox. 

7. Double-click in the From field, then type the number of the first treatment session 

to select. 

8. Double-click in the To field, then type the number of the last treatment session 

that you want to select. 

9. Repeat steps 1-3. 

Closing an Incomplete Calendar Session 

1. In the Treatment Chart, click , then click a treatment field that you 

partially treated. 

2. Click . 

3. In New Status group of the Record Status dialog box, click Approved. 

4. Type your Password field, then click . 

5. Click the treatment session you approved, then click . 

6. In New Status group of the Record Status dialog box, click Closed. 


Scheduling Treatment Sessions with Incomplete Information 

1. Right-click or press F4 in the Diagnoses and Interventions window, then click 

Add Tx Field without Rad Rx…. 

2. In the Treatment Field Definition dialog box, add field information for new field. 

3. Repeat steps 1 and 2 to create all of the fields that you do not want associated 

with a prescription. 

4. Click , then click to open the Treatment Calendar. 

5. Remove the existing treatment sessions in the Treatment Calendar. 


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Notes 6. Click , click Other, then click . 

7. In the End group of the Wave Setup Form dialog box, type the number of 

sessions in the Times field. 

8. Click . 

9. Click . 

10. In the Results of Inserts Sessions message box, click . 

Adding a Field Group First When Scheduling Treatment Sessions 


2. In the Fields To Be Scheduled dialog box, right-click or press F4, then click 

Show Treatment Fields for All Courses. 

3. Add the treatment fields not associated with a prescription that make up the field 

group. 

4. In the Fields To Be Scheduled dialog box, click . 

5. Click . 

6. Click Assign Fields Defined on “Schedule Fields” to each 

Inserted Session. 

7. Click Other, then click to open the Wave Setup Form dialog box. 

8. Type the date on which you want treatment to start in the Date field. 

9. In the End group, type the number of sessions in the Times field. 

10. Click . 

11. Click . 

12. In the Results Insert Sessions message box, click . 

Scheduling AFS Treatment Sessions 

1. In the Treatment Calendar, add treatment sessions for the prescription site, then 

click . 

2. In the Fields To Be Scheduled dialog box, click , then click 

. 

3. Add the treatment fields to include in the AFS group to the Fields to be Scheduled 

pane. 

4. Click .


Notes 5. In the Schedule Fields tab of the Treatment Calendar, click . 

Scheduling MFS Treatment Sessions 

1. In the Treatment Calendar, add treatment sessions for the prescription site, then 

click . 

2. In the Fields To Be Scheduled dialog box, click , then click 

. 

3. Add the treatment fields to include in the MFS group to the Fields to be Scheduled 

pane. 

4. Click . 


Scheduling a QA Mode Treatment Session 

1. In the Treatment Calendar, double-click the treatment session you want to 

schedule as a QA mode treatment session. 

2. In the Treatment Calendar Session dialog box, right-click or press F4. 

3. In the Treatment Calendar Session Options menu, click QA Mode. 

4. Click . 


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Notes



LTGRAD0005C/1.0/31-Mar-2009 

Lesson 10 eCHART Chart 

Check 

Objectives 

You will learn how to: 

• Open and review the eCHART Chart Check 

• Review eCHART Chart Check notes 

The eCHART Chart Check feature reports changes made to your electronic charts 

since the last chart check. This supports your weekly chart reviews. IMPAC 

recommends that you automatically save the results of each Chart Check as a patient 

note. You can configure this setting in Department Setup. You can also automatically 

capture your weekly physics charge codes and print reports for each chart checked. In 

this lesson, you will open and review the eCHART Chart Check, and review 

eCHART patient notes. 

The eCHART Chart Check only reviews chart activity. Use the 

quality checklist feature as a task reminder system. 

To use eCHART Chart Check, you must have Clinical | Dosimetry 

Gen | View and Modify security rights. 

To work with Quality Checklists, you must have Admin | Quality 

Checklist | View and Modify security rights. 

To capture charges and print charge reports, you must have 

Administrative | Code Capture | Modify security rights. 

To view Diagnoses and Interventions window, you must have 

Clinical | General | View security rights. 

To run and print reports, you must have Admin | Administrative | 

General | View and Modify security rights. 

To view and add patient/clinical notes and email, you must have 

Clinical | Notes | View and Modify security rights.

Lesson 10: eCHART Chart Check 


LTGRAD0005C/1.0/31-Mar-2009 

Notes 

Reviewing the eCHART Chart Check 

You must run the eCHART Chart Check to review changes made to the radiation 

treatment chart over a selected time period. In this exercise, you will run the eCHART 

Chart Check. 

1. Open the chart for your lesson patient, then click eChart | Chart Check…. 

Opens the Chart Check Options dialog box, shown in Figure 70. 

Figure 70: Chart Check Options Dialog Box 

Use the Chart Check Options dialog box to identify whether to charge for the 

chart check, chart check printing options, and the date from which to check the 

chart. The Chart Check Options dialog box contains the fields and components 

below: 

Patient(s) to Check 

Current Specifies to check only the currently active patient chart. 

Tagged Specifies to manually select a batch of patient charts to 

check. When you click this filter, the Select Patient window 

opens after you click . This lets you tag the 

patient charts to check. 

All Specifies to check all charts for patients with an Active 

status.


Notes By MD Specifies to restrict which charts to check by physician. 

Click to enable the MD field, then click to open the 

Staff Directory. Use the Staff Directory to select/add a 

physician. Only patients with a Selection List status of 

Active and On Break are included in the chart check when 

you use this filter. 

By Machine Specifies to restrict which charts to check, by machine and 

date range. This filter lets you chart check all patients 

treated (or scheduled to be treated) on a specific machine 

within a specified date range. This filter functions 

independent of patient status. 

Charge 

Click to enable the Machine field, then click to open the 

Location Directory. Use the Location Directory to 

select/add a treatment machine. After you choose a 

machine, the Enter Data Range dialog box automatically 

appears. You can type or click the dates from which to 

select charts (the dates are inclusive). The dates then appear 

in the From and To fields. 

No Specifies that you do not want to capture a charge code 

for a procedure when you do the chart check. 

Prompt Specifies to open the Code Capture dialog box after each 

chart check. The charge code in the Activity field is 

automatically added in the Code Capture dialog box. You 

can also manually click a code to capture. 

Auto Specifies to automatically capture the code specified in the 

Activity field when the chart check is complete. 

Activity Specifies the procedure whose code you want captured. If 

you click Prompt or Auto, the Activity field becomes active. 

You can then click an activity from the Select Procedure 

dialog box. 

Include 

Billing 

Comment 

Print 

Specifies whether to add the default billing comment 

(Chart Checked) with the code capture. This checkbox 

only appears when you click Prompt or Auto. 

No Specifies to not print a report when the chart check is 

complete. 


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Notes Prompt Specifies to prompt whether to print the chart check after 

each chart check. 

Auto Specifies to print a report when each chart check is 

complete. 

Check Since 

Last Check Specifies to perform a check from the completion 

date/time of the last chart check onward. 

Beginning Specifies to perform a complete check for the chart(s) 

from the date of the first activity through the current date. 

Other Specifies a start date for the chart check, such as activities 

from that date and the current date in the check. When 

you click Other, the Date field is enabled to let you add a 

start date. Click to open the Calendar tool, then click 

the start date. 

2. Click Current in the Patient(s) to Check group. 

Specifies to check only the currently selected patient. 

3. Click Prompt in the Charge group. 

Specifies to prompt to capture a charge when you do the eCHART Chart Check. 

4. Click adjacent to the Activity field. 

Opens the Select Procedure dialog box, shown in Figure 71. 

Figure 71: Select Procedure Dialog Box


Notes 


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LTGRAD0005C/1.0/31-Mar-2009 

Notes 5. Click Physics in the Group column, then double-click Physics 

Consultation in the Description column. 

Selects the activity to charge for when running the chart check. The code appears 

in the Activity field, with a description below it. 

6. Click Prompt in the Print group if not already selected. 

Specifies to ask before it prints the checklist report as shown in Figure 72. 

7. Click . 

Figure 72: Chart Check Options Completed 

Does the chart check, then opens the Chart Check window, shown in Figure 73.


Notes 

Figure 73: Chart Check Window 

The Chart Check window has 2 sections. The top section contains the 

information you added in the Chart Check Options dialog box. The text box 

shows the electronic charting information of the selected patient in blue text. You 

can click the blue text, then click to open the applicable window or 

dialog box for the selected information. 

8. Click Lung in blue text under the Diagnosis Checked category. 

Selects the entire line of information in the Diagnosis Checked category. 

9. Click . 

Opens the Diagnosis and Staging window for the selected blue text in the Chart 

Check window. You can also double-click the blue text. 

10. Click . 

Closes the Diagnosis and Staging window. 

11. Use the scroll bar to scroll through the chart check. 

The diagnosis, prescription, and simulations for this patient are automatically 

added in the table. 


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Saves the checklist as a patient note, then opens the Code Capture dialog box, 


Figure 74: Code Capture Dialog Box for Completed eCHART Chart Check 

The Code Capture opens because you added the procedure in the Activity field 

on the Chart Check Options dialog box. 

13. Click . 

Captures the code, then opens the Print Chart Check message box, shown in 

Figure 75. 

14. Click . 

Figure 75: Print Chart Check Message Box 

Prints the chart check report, then closes the Chart Check dialog box. An example 

of the report is shown in Figure 76.


Notes 

Figure 76: Chart Check Report – Printed 


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LTGRAD0005C/1.0/31-Mar-2009 

Notes 

Reviewing eCHART Chart Check Notes 

If you click from the Chart Check window, MOSAIQ saves the 

information as a patient note if configured to do so. You cannot change the 

information in a patient note saved from an eCHART chart check. In this exercise, 

you will review eCHART Chart Check notes. 

1. Click eChart | Notes…. 

Opens the Patient Notes window. 

2. Click All Patient Notes from the View field. 

Shows the eCHART Check note, shown in Figure 77. 

Figure 77: Patient Notes Window with eCHART Check Note 

If the eCHART Check heading does not appear in the Type column, 

contact your system administrator. Your system administrator 

must click File | System Utilities | Department Setup… to open 

the Department Setup dialog box. Click the Clinical (RO) tab, 

then click the Save Chart Checklist as Note checkbox in Chart 

Check Options group. 

The eCHART Check note type is automatically locked, as shown by the asterisk 

(*) adjacent to eChart Check in the Type column. You cannot change or remove the 

note. 

3. Double-click the eCHART Check note. 

Opens the Patient Note window, shown in Figure 78.


Notes 

Figure 78: Patient Note Window 

4. Use the scroll bar to scroll through the note. 

5. Right-click in the Patient Note window. 

Opens the Patient Note Options menu, shown in Figure 79. 

Figure 79: Patient Note Options Menu 

The Unlock option is grayed out. You cannot change Chart Check notes. The 

active commands are: 

Mail To Opens the Select Directory dialog box, which prompts you 

to select either Staff or Location. Use the selected directory to 

tag the staff members or locations to which to send the 

eCHART Check note. Click to send it to the staff 

member or location from the MOSAIQ mail feature. 

Print Note Prints a copy of the note. 


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LTGRAD0005C/1.0/31-Mar-2009 

Notes


Notes 6. Click in the Patient Note window, outside of the Options menu. 

Closes the Options menu and opens the Patient Note window. 

7. Close all dialog boxes and windows. 

What’s Next 

Congratulations! You have completed Module III of the Dosimetrist/Physicist 

training guide. In this lesson, you learned how to open and review the eCHART Chart 

Check. You also learned how to review eCHART Chart Check notes. Use the Quick 

Version as a concise, step-by-step guide when you must quickly apply any of the skills 

you have learned in this lesson or if you simply want to reinforce what you have 

learned. 


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LTGRAD0005C/1.0/31-Mar-2009 

Notes 

Quick Version 

Running and Reviewing the eCHART Chart Check 

1. Open the chart for your patient, then click eChart | Chart Check… to open 

the Chart Check Options dialog box. 

2. Click Current in the Patient(s) to Check group. 

3. Click Prompt in the Charge group. 

4. Click adjacent to the Activity field. 

5. Click the group, such as Physics, in the Group column, then double-click the 

procedure, such as Physics Consultation, in the Description column. 

6. Click Prompt in the Print group. 

7. Click to open the Chart Check window. 

8. Click the blue text in the text box. 

9. Click to open the applicable window or dialog box for the selected 

blue text. 

10. Close the dialog box or window. 

11. Use the scroll bar to scroll through the checklist. 

12. Click to save the checklist as a patient note, then open the Code 

Capture window. 

13. Click in the Code Capture dialog box. 

14. Click in the Question message box to print the chart check. 

Reviewing eCHART Chart Check Notes 

1. Click eChart | Notes…. 

2. Click All Patient Notes from the View field. 

3. Double-click the eChart Check note. 

4. Use the scroll bar to scroll through the note. 

5. Right-click in the Patient Note window to open the Patient Note Options menu. 

6. Click in the Patient Note window, outside of the Options menu to close the 

Options menu.



LTGRAD0005C/1.0/31-Mar-2009 

Appendix A Getting Your 

System 

Started 

After your system is configured, you can add patients currently under treatment and 

begin tracking them the same as new patients. There are 2 basic tasks when you add 

an existing patient: add the patient with the diagnosis, prescription, and treatment 

fields, then manually record all dose delivered to date. This appendix provides 4 

different options to retrofit and populate your system with your current patient 

information. Each option includes a typical example for the option, a basic outline of 

the steps, a list of benefits for the option, and a list of drawbacks for the option. For 

details about the steps in each option, refer to the applicable lesson in this guide, or 

refer to the MOSAIQ documentation. 

Option 1: Add the Prescription, Manually Record 

Treatments, Then Treat Remaining Fields from 

the System 

Patient Setup 

Consider the patient information below as a typical example for Option 1: 

• The physician prescribes 4500cGy at 180 per day (25 fractions and Daily 

fractionation). The radiation oncologist adds 1 basic radiation prescription. 

• Before you changed to MOSAIQ, the patient received 4140 cGy at 180 per day 

(23 fractions). The clinician manually records the 23 treatments and adds the start 

date and the correct total MU per field. 

• The remaining dose to be delivered is 360 cGy (2 fractions). The clinician uses the 

Treatment Chart/Calendar to schedule and treat the remaining dose. 

Use the steps below to set up the patient per Option 1: 

1. Add a diagnosis and course of therapy for the patient, the same as for new 

patients. Refer to Lesson 2 in Module I of this guide for details. 

2. Add a prescription for the patient, the same as for new patients. Refer to Lesson 

2 in Module I of this guide for details. 

3. Add treatment fields for the patient, the same as for new patients. Refer to 

Lesson 3 in Module I of this guide for details. You can also import/export MLC 

files and RTP files (such as IMRT files). Refer to Appendix A in Module II

Appendix A: Getting Your System Started 


LTGRAD0005C/1.0/31-Mar-2009 

Notes (import/export MLC files) and Lesson 5 in Module II (import/export RTP files) 

of this guide for details. 

4. Set up dose tracking for the patient, the same as for new patients. Refer to Lesson 

6 in Module II of this guide for details. 

5. Manually record the dose delivered to date as a single treatment session. Refer to 

Lesson 7 in Module II of this guide for details. 

6. Use the Treatment Chart/Calendar to schedule and treat remaining fractions. 

Refer to Lesson 9 in Module III (schedule treatments) and Lesson 7 in Module II 

(manually record treatments) of this guide for details. 

After you complete the steps for this option, the Treatment Chart for your 

patient shows a mismatch for the manually recorded treatments. The Treatment 

Chart window will look similar to Figure 80, which is based on the patient 

information given in the example for this option. 

Mismatch for the manually recorded treatments 

Figure 80: Treatment Chart Window with a Mismatch 

The Radiation Prescriptions dialog box also only shows 1 fraction treated. This 

appears even though you manually recorded multiple treatments for dose 

delivered. The actual dose based on your manually recorded treatments does 

appear in the upper pane of the Radiation Prescriptions dialog box. Your 

Radiation Prescriptions dialog box should look similar to Figure 81, which is 

based on the patient information for this option.


Notes 

Figure 81: Radiation Prescriptions with Incorrect Fractions Treated 

Benefits of Option 1 

• It is relatively quick and easy to add the dose delivered to date. 

• The staff does not have to deal with mismatches or warnings when they deliver 

treatments. 

• The current and total dose in the Treatment Chart and eCHART Navigator 

match. 

Drawbacks of Option 1 

• The Treatment Chart window will show a red mismatch for the manually 

recorded treatments. 

• The prescription will only show 1 fraction as treated instead of the actual number 

of treated fractions. 

• The Dose and Fraction Review window will show an Excess Treatment, a Projected 

Actual/Rx mismatch, and inaccurate data for the To Date Actual/Rx and Remaining 

Rx in the Dose and Fraction Summary section as shown in Figure 82. Figure 82 is 

based on the patient information given in the example for this option. 


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LTGRAD0005C/1.0/31-Mar-2009 

Notes 

Figure 82: Dose and Fraction Review Window with Inaccuracies 

Option 2: Add a Prescription with Phases, 

Manually Record Treatments, then Treat 

Remaining Fields from the System 

Patient Setup 

Identifies a mismatch. Displays inaccurate data. 

Identifies an excess treatment delivered. 


• The physician prescribes 4500cGy at 180 per day. 


(23 fractions). The radiation oncologist creates a prescription that documents the 

dose delivered to date (4140 cGy) as 1 fraction. 

• The clinician manually records the treatment for the dose delivered to date (4140 

cGy) and adds the start date and the correct total MU per field. 

• The clinician then appends the prescription to show the remaining 

dose/treatments in a second fractionation phase that includes a total prescribed 

dose of 360 cGy, a fractional dose of 180, and a Daily fractionation pattern. 

• The clinician uses the Treatment Chart/Calendar to schedule and treat the 

remaining dose.


Notes Use the steps below to set up the patient per Option 2. 

1. Add a prescription for the patient, documenting the dose delivered to date as 1 

fraction with a Daily fractionation pattern. Add the remaining prescribed and 

fractional doses in a second fractionation phase. Refer to Lesson 2 in Module I of 

this guide for details. 


Lesson 3 in Module I of this guide for details. Refer to Appendix A in Module II 

(import/export MLC files) and Lesson 5 in Module II (import/export RTP files) 




4. Manually record dose delivered to date and add the start date and the correct 

total MU per field. Refer to Lesson 7 in Module II of this guide for details. 




The original radiation prescription should look similar to Figure 83. Figure 83 is 

based on the patient information given in the example for this option. 

Figure 83: Radiation Prescriptions Dialog Box with 1 Fraction for Dose 

Delivered to Date 

The appended radiation prescription should look similar to Figure 84. Figure 84 

is based on the patient information given in the example for this option. 


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LTGRAD0005C/1.0/31-Mar-2009 

Notes 

Figure 84: Radiation Prescriptions Dialog Box with Fractions Appended for 

Remaining Dose 

Benefits of Option 2 

• There are no mismatches in the Treatment Chart window for the manually 

recorded treatments. 

• There are no mismatches or inaccuracies in the Dose and Fraction Review 

window. 


• It takes more work to append the prescription. 

• The staff must acknowledge the Projected Rx Mismatch warnings when they 

manually record treatments in the Treatment Delivery Table dialog box. 

• The system displays 3 fractions rather than the actual 25 delivered.


Notes 

Option 3: Add a Prescription for the Remaining 

Dose Only (cGy), Do Not Manually Record 

Treatments or Retrofit, then Only Treat 

Remaining Fractions from the System 

Patient Setup 




(23 fractions). 

• The radiation oncologist adds a prescription only for the remaining dose (360cGy 

with a fractional dose of 180), and must add a note in the prescription to record 

the abbreviated prescription. 

• The clinician uses the Treatment Chart/Calendar to schedule and treat the 

remaining dose. 

Use the following steps to set up the patient per Option 3. 



2. Add a prescription only for the remaining dose, and add a prescription note to 

record the abbreviated prescription. Refer to Lesson 2 in Module I of this guide 

for details. 



files and RTP files (such as IMRT files). Refer to Appendix A in Module II 








Benefit of Option 3 

It involves much less work because you do not have to retrofit the patient 

information. 


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LTGRAD0005C/1.0/31-Mar-2009 

Notes 


• The treatment shown as delivered in the electronic chart does not reflect the actual 

total dose prescribed and delivered. 

• If you keep the paper chart, it does not match the electronic chart. 

Option 4: Add a Prescription for the Entire Dose 

(cGy) and Deliver Manually Recorded 

Treatments for All Fractions 

Patient Setup 

Consider the following patient information as a typical example for Option 4: 



(23 fractions). 

• The therapist creates a prescription for the entire dose (4500cGy with a fractional 

dose of 180 and a Daily fractionation pattern). 

• The therapist manually records all the treatments. 

• The therapist adjusts the dates for each treatment field, so that the system records 

the correct date. 

Use the following steps to set up the patient per Option 4. 



2. Add a prescription for the patient, the same as for new patients. Refer to Lesson 

2 in Module I of this guide for details. 



files and RTP files (such as IMRT files). Refer to Appendix A in Module II 





5. Add a Treatment Calendar with same start date as the date when the patient 

treatment started. Refer to Lesson 9 in Module III for details. 

6. Manually record the dose delivered to date for each treatment session with the 

actual treatment dates. Refer to Lesson 7 in Module II of this guide for details.


Notes Benefits of Option 4 

• The electronic chart accurately shows all treatments delivered. 

• The fractions that appear in the system are correct. 

• There are no mismatches anywhere in the system. 

Drawback of Option 4 

It is time consuming. 


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LTGRAD0005C/1.0/31-Mar-2009 

Notes



LTGRAD0005C/1.0/31-Mar-2009 

Appendix B Dose 

Calculation 

Cases can arise in which it is advantageous to track partial dose contribution to 

secondary dose sites. An example is dose to mid-axilla from a superclavicular field or 

total body treatment plans and off-axis treatment plans in which the dose site 

coefficients for the contributing fields may not be equal to 1. Refer to the dose 

calculations implemented in MOSAIQ below so that you can understand how Total 

Dose is determined. 

Definitions 

The definitions are used in the dose calculation are follows: 

Field Dose 

Coefficient (FDC) 

Dose Site 

Coefficient (DSC) 

Historical 

Treatment MU 

(TMU) 

Dose Site Dose 

(DSD) 

The field dose divided by the field MU. FDC is a calculated 

value and appears in the MU/Dose Specification dialog 

box, Dose/MU field. 

The coefficient that equals the dose delivered to the site 

from that field when multiplied by the dose contributed to 

the field. The DSC is defined in the Dose Site Coefficient 

dialog box, Coefficient field, when you complete dosimetry 

setup. 

The MU recorded for each treatment field or portal image 

exposure. 

The Dose delivered to a site per treatment as determined by 

the MU delivered multiplied by the FDC and DSC. 

Session A specific time period over which any delivered dose is 

combined into a single fraction, which is configurable. 

The above coefficients are saved to 3 decimal places.

Notes 

Calculation 

Copyright 2009, IMPAC Medical Systems 

Appendix B: Dose Calculation 

1. The Dose Site Dose is calculated for each historical treatment record: 

DSD = TMU * FDC * DSC. 

2. The Dose Site Doses from dose history records for the same treatment field and 

within the same treatment session are added together. 

3. The same field/same session DSD is rounded to the nearest cGray (or Gray 

depending on the dose unit configured at your facility in the Dosimetry 

Configuration dialog box). 

4. For each field/session, the rounded dose is added to the running total to give the 

Total Dose. 

The Total Dose value calculated above is the Total Dose that appears in the 

SEQUENCER table, eCHART Check, Dose Site Summary window and report, 

and in the Treatment Chart. 

The Daily Treatment Summary still shows field dose rounded 

to the nearest cGray per historical treatment, where Field 

Dose = TMU * FDC.

Course Evaluation: Dosimetrist/Physicist 

Module III 

Now that you have completed Dosimetrist/Physicist Module III Training, please answer the following by placing a 

checkmark in the appropriate box. Mark the tasks that were covered in class on the left, then indicate your “comfort” 

level with each task that was covered in class. Each task is followed by a lesson reference. If you answer “Cannot do” 

for any of the tasks, you can refer to the appropriate lesson in the Training Guide to review the course information. 

Check tasks 

covered 

Can you do the following tasks? 

Scheduling Treatment Sessions for a Single Prescription 

Can do 

Can do 

with 

help 

Cannot 

do 

(Lesson 9) 

 

Removing a Treatment Field in the Treatment Calendar 

(Lesson 9) 

 

Scheduling Treatment Sessions for Multiple Prescriptions 

(Lesson 9) 

 

Scheduling Treatment Sessions for a Single Prescription with 

an Alternating Pattern (Lesson 9) 

Scheduling Ad Hoc BID Treatment Sessions (Lesson 9) 

 

Scheduling Treatment Sessions for Overlapping Treatments 

(Lesson 9) 

 

Adding a Treatment Field to an Established Treatment 

Calendar (Lesson 9) 

 

Changing the Treatment Sequence in the Treatment 


 

Removing a Treatment Field in the Treatment Calendar 

(Lesson 9) 

 


(Lesson 9) 

 

Adding a Portal Image to an Established Treatment 


Removing a Portal Image (Lesson 9) 

 

Adding a Series of Portal Images to an Established 

Treatment Calendar (Lesson 9) 

Changing All Treatment Sessions Due Dates (Lesson 9) 

 

Making Ad Hoc Treatment Session Date Changes 

(Lesson 9) 

Changing a Single Treatment Session Due Date (Lesson 9) 

 



Approving a Treatment Session (Lesson 9) 

Copyright 2009, IMPAC Medical Systems 106

Check tasks 

covered 

Can you do the following tasks? 

Can do 

Can do 

with 

help 

Course Evaluation 

Cannot 

do 

Closing an Incomplete Calendar Session (Lesson 9) 

 

Scheduling Treatment Sessions with Incomplete Information 

(Lesson 9) 

 

Defining a Field Group First When Scheduling Treatment 

Sessions (Lesson 9) 

Scheduling AFS Treatment Sessions (Lesson 9) 

Scheduling MFS Treatment Sessions (Lesson 9) 

Scheduling a QA Mode Treatment Session (Lesson 9) 

 

Running and Reviewing the eCHART Chart Check 

(Lesson 10) 

Reviewing eCHART Chart Check Notes (Lesson 10) 

Name: Date: 

Facility: 

Copyright 2009, IMPAC Medical Systems 107

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Dosimetrist/Physicist Training Guide - UCSF Radiation Oncology

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