Adaptive readiness
Is your team ready
for adaptive?
The most demanding credentialling environment in modern radiation oncology.
As you read, answer four quick questions about your department.
Your answers carry into the readiness check.
Online adaptive
Who on your team needs credentialling, and for what?
Online adaptive treatments, where plans are modified in real time with the patient on the treatment table, make clinical decisions in minutes. The competency required is task-specific, technology-specific, and cannot be assumed from general qualifications.
MR-Linac (Unity, ViewRay)
- Who needs credentialling
- Radiation oncologists, medical physicists, radiation therapists, nursing
- Key competency areas
- MR safety, online contouring, adaptive plan approval, image interpretation
- Reference
- ESTRO-ACROP 2021; AAPM TG 284; ACPSEM MRILWG 2023
CBCT adaptive (Ethos)
- Who needs credentialling
- Medical physicists, dosimetrists, radiation therapists
- Key competency areas
- Automated segmentation review, plan selection, workflow-specific QA
- Reference
- AAPM TGs 384 & 395 (in development); Shepherd et al. 2021
MR-guided SBRT
- Who needs credentialling
- Radiation oncologists, medical physicists
- Key competency areas
- Gating, real-time tracking, online plan adaptation, motion management
- Reference
- ASTRO ART Safety White Paper 2024; AAPM TG 100
Online adaptive (any platform)
- Who needs credentialling
- The full clinical team
- Key competency areas
- Role-specific competency maps, decision-support tool use, on-call protocols
- Reference
- Shepherd et al. TIPSRO 2021; Hogan et al. J Med Radiat Sci 2023
Offline adaptive
The on-ramp to online adaptive, and an unrecognised exposure.
Offline adaptive treatments, where replanning happens between fractions based on accumulated dose, volumetric imaging, or clinical response, require equally rigorous competency frameworks. Each step involves a different role, a different competency, and a different credentialling requirement. None can be assumed from the original treatment plan approval.
Offline adaptive involves weekly or triggered replanning based on anatomical change, accumulated dose analysis and dose-volume constraint review, adapted volume delineation and peer review, plan comparison and approval workflows, and the clinical decision on when to adapt rather than treat as planned.
| Role | Credentialling required for |
|---|---|
| Radiation oncologists | Volume adaptation, clinical decision authority |
| Medical physicists | Dose accumulation, constraint review, plan QA |
| Dosimetrists | Adaptive planning, constraint optimisation |
| Radiation therapists | Imaging acquisition, workflow execution |
Many departments are already running offline adaptive workflows without formal task-specific credentialling. This is an unrecognised compliance exposure, and one that accreditation bodies are increasingly scrutinising.
Procedure versions
Which version of the procedure was each person signed off against?
In AyniHealth, every competency record is tied to the version of the procedure document it was signed off against. Your department plugs in its own procedure documents and vendor material, and each sign-off records the version that was current when it was given.
When a document changes, the record shows who was signed off against the earlier version, and the change reopens their sign-off so the affected roles review it and are signed off again. At audit you can show not only that someone was credentialled, but what they were credentialled against.
Beyond a single procedure
Adaptive requires more complex monitoring.
Clinical credentialling is not a one-time event. The literature is explicit that competencies require ongoing verification, and adaptive tests that on four dimensions at once.
New technology introduction
When a new unit or technique goes live, how do you know every affected role has been re-credentialled?
What needs tracking
Entire team re-credentialled when new equipment or treatment technique is introduced, per AAPM guidelines.
How AyniHealth helps
Implementation of a new treatment unit triggers a credentialling workflow for every affected role. No manual tracking.
Role-based competency maps
Does each role have its own competency map for the same adaptive procedure?
What needs tracking
Oncologist, physicist, dosimetrist, RTT, nursing. Each role has different competency requirements for the same procedure.
How AyniHealth helps
Role-specific competency pathways configured per department. Each clinician tracks against their own map.
Scope of practice
Could you show that people only perform the adaptive tasks they are credentialled for?
What needs tracking
Evidence that staff are only performing tasks they are credentialled to perform. Critical for medico-legal protection.
How AyniHealth helps
Credentialling records linked to treatment assignments. Scheduling grounded in verified capability, not assumptions.
New staff onboarding
Do new staff demonstrate competency before they work independently, or only complete training?
What needs tracking
New clinicians must demonstrate competency before performing procedures independently, not just complete training.
How AyniHealth helps
Structured onboarding pathways with milestone tracking. Supervisor sign-off required at each stage. Probationary credentialling until independence is verified.
Annual review, CPD and maintenance of certification, and revalidation after time away matter too, and they are covered on the credentialling page.
Choosing a system
What an LMS, a spreadsheet and AyniHealth are each good for.
An LMS or a spreadsheet is the right tool for plenty of departments. The difference shows once you need evidence that is specific to the task, the role and the version of the procedure.
| What you need | LMS | Spreadsheet or project tool | AyniHealth |
|---|---|---|---|
| Delivering and recording training | Strong. This is what an LMS is built for, and if your need ends at course completions, it is enough. | Workable for a small team, with manual upkeep. | Records training too, though adaptive credentialling needs more than training records. |
| A competency map for each role | Usually organised by course rather than by role and task. | Entirely possible, and fine for one unit and a stable team. | A map for each role, configured by your department. |
| Re-credentialling when a unit or technique changes | Manual. Someone has to re-enrol the right people. | Manual, and easy to miss once the person who built it moves on. | A change starts the credentialling workflow for every affected role. |
| Sign-off tied to the procedure version | Rarely. Completion is recorded against a course, not a document version. | Only if someone adds a column for it and keeps it current. | Every sign-off records the document version it was given against. |
| Evidence at audit | Completion reports, which are useful but say little about competency. | As good as the last update. | Who was credentialled for what, against which version, and when. |
| Effort to start | Often already in place, which counts for a lot. | Close to none. | A set-up project with your department, which pays off once adaptive grows beyond a few people. |
If your adaptive team is small and stable, a well-kept spreadsheet may serve you well for now. The case for a system grows with every role, unit and procedure change you add.
Launch partners
Ready to pilot adaptive credentialling?
We are inviting a small number of departments to pilot AyniHealth on a live adaptive programme. Your team leads the change, and AyniHealth helps it work at scale and gives you confidence at audit.
The pilot runs on two products in build. The Adaptive Credentialling Worklist in AyniHealth Catalyst™ tracks every task, role and tier as your team works, and the Adaptive Learning Journey in AyniHealth Connect™ ties each workflow unit to the documents and reading your department chooses. Launch partners shape both before they are generally available.