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

A ProKnow snapshot survey was done at the start of the NHSE evaluation in April 2023, for which around half of all centres submitted a response. This survey could be repeated in April 2024 (during NHSE evaluation) and April 2025 (at the end of the NHSE evaluation) to capture data relating to using ProKnow at the different stages of its implementation to monitor uptake and use of the technology over time.

Survey results depend on comprehensive distribution of the survey across the NHS and on the sample of respondents being representative of the target population. The survey is an additional to the existing workload and demands on staff. Data collection should be restricted to essential outcomes only and the survey widely distributed across the target audience.

Currently, there are no mandatory data collection stipulations as part of the NHSE evaluation (up to March 2025). This can lead to differences in what is reported between services. Some treatment plan data (such as 4D imaging that may be used in people with breast cancer) cannot be uploaded to ProKnow. So, the data collection may not be generalisable to all cancers or treatment modalities.

National guidance for some aspects of radiotherapy treatment planning may be lacking. For example, the Royal College of Radiologists recommends using departmental protocols for peer review, plan definitions and quality assurance. So, practice may differ between centres and standards may not be available to audit against.

Communication with data-holding centres may encourage data completeness, but inherent biases may remain in both local and national data collections. So, the robustness of the desirable outcomes within the time-series study should be considered.

Resources and communication to increase awareness and engagement with data collection and analyses should be considered. This could be through existing professional groups and steering organisations involved in the NHSE evaluation.

Staff time and resources to support data entry to ProKnow should be considered. Burdens could be alleviated by providing analytic or scripting support to ease data transfer.

Clear processes for reporting adverse events associated with ProKnow should be in place, for example, reporting interoperability issues to the ProKnow Clinical Leadership and Implementation Group or company.