# Round-the-clock remote treatment-planning hubs for clinics without physicists

Source: https://onco.cc/ideas/idea-acc-remote-planning-hubs/  
OnCo record `idea-acc-remote-planning-hubs` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Hospitals without enough physicists could upload scans to a shared planning centre, where AI drafts the treatment plan and remote experts finish and check it within a day.

## Summary

Radiotherapy planning (contouring organs and target, optimising beams, quality assurance) is the scarcest skill in radiotherapy centres that lack physicists and dosimetrists. A cloud planning hub combining AI auto-segmentation with a pooled roster of dosimetrists and physicists in higher-capacity centres would turn a two-week wait into a 24-hour service. Commercial contouring software already exists; the missing piece is the organisational and regulatory model that lets a physicist in one country sign off a plan for another.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- Hypothesis: A regional planning hub will reduce median simulation-to-first-treatment time from more than 14 days to under 5 days in participating centres, with plan-quality audit scores at least equal to locally produced plans.
- Rationale: Teleradiology proved that image interpretation can be pooled across borders with quality maintained; planning is a similar knowledge-work bottleneck with a structured output that is easy to audit.
- Proposed test: A twelve-month pilot in five LMIC centres with blinded plan-quality review by an independent physics group, time-to-treatment and re-plan rates as endpoints, and a costed model of hub economics.
- Maturity: early-clinical
- Actor: engineering

## Sources

- Bottleneck evidence (Most of the world has almost no cancer care): WHO fact sheet, Cancer: https://www.who.int/news-room/fact-sheets/detail/cancer

## Connected records

- fronts: [AI & Computation](https://onco.cc/fronts/ai-computation/), [Radiation Therapy](https://onco.cc/fronts/radiation/)
- technologies: [IMRT / IGRT (modern external beam)](https://onco.cc/technologies/imrt-igrt/)
- bottlenecks: [Most of the world has almost no cancer care](https://onco.cc/bottlenecks/b-global-access/), [Not enough oncologists, nurses, pathologists, physicists](https://onco.cc/bottlenecks/b-workforce/)
- ideas: [One medical physicist covering many radiotherapy machines through remote quality assurance](https://onco.cc/ideas/idea-acc-remote-medical-physics-qa/)
- roadmaps: [Global access and affordability roadmap: essential medicines and generics → biosimilars and frugal trials → reliance, pooling and homegrown innovation](https://onco.cc/roadmaps/global-access-roadmap/), [Radiotherapy roadmap: X-rays → shaped beams → fewer fractions, particles and FLASH](https://onco.cc/roadmaps/radiation-roadmap/)

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