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Advanced service technology keeps busy Spanish radiotherapy department up and running

Elekta Care

Elekta IntelliMax® helps Hospital Provincial de Castellón maintain continuity of patient care, through patented service monitoring of the center’s radiation therapy systems


Members of the Hospital Provincial de Castellón radiophysics team

The founding of Hospital Provincial de Castellón dates back to 1394, a year in which clinicians likely had difficulties treating even the simplest maladies, let alone cancer. But what these 14th century doctors didn’t have to contend with were ultra-complex cancer treatment systems and their associated maintenance. Fortunately, nothing gets past Elekta IntelliMax, patented remote monitoring technology used for preventive and predictive maintenance. IntelliMax enables maximized radiotherapy equipment uptime.

Agustin Santos-Serra, MSc, the center’s chief of radiophysics, was keen to ensure the systems in his busy clinic remain fully operational. Each unplanned interruption can have a major impact on patient care, so his team sought out the latest service technology solutions.

“Hospital Provincial de Castellón was among the first hospitals in Spain to implement IntelliMax for an Elekta Synergy® system installed in 2006, and then for two Versa HD™ machines acquired in 2017 and 2020,” Santos-Serra says. “In 2018, we also were one of the early adopters of IntelliMax connectivity to our MOSAIQ® Oncology Information System [OIS].”

With his home just a 15-minute drive from the hospital – the latter located in Castellón de la Plana – Elekta technical service engineer David Reinado uses IntelliMax to monitor the linacs’ status and respond to any alerts concerning the systems’ health and functionality – often before the clinic staff knows there is an issue.


Agustin Santos-Serra, MSc, chief of radiophysics at Hospital Provincial de Castellón

“I check IntelliMax every day for their linacs and Agustin is aware of that,” Reinado says. “Through IntelliMax, I can remotely view and operate the systems’ software with the hospital’s permission. And, because I live close by, I regularly visit the center to speak with members of the radiophysics department about other service needs.”

IntelliMax real-time monitoring alerted Reinado that the electron guns on Hospital Provincial de Castellón’s Elekta Synergy and first Versa HD were nearing their lifespans. The electron gun emits electrons that are accelerated down the waveguide toward the target to produce radiation.

“IntelliMax enabled me to get an accurate picture of the gun’s true age, so the component wouldn’t have to be replaced prematurely or experience a sudden failure that causes hard downtime during clinic hours when patients are treated,” Reinado says.

For both of these issues, the hospital avoided unplanned downtime, according to Santos-Serra.

“We estimate that replacing the electron guns reactively after they’ve failed would have cost us over 15 hours of unplanned downtime, versus just six hours of planned downtime.”


Elekta technical service engineer David Reinado

“David was able to arrange for the parts’ replacement and then replace them during a planned maintenance period when we weren’t treating patients,” he observes. “We estimate that replacing the electron guns reactively after they fail would have cost us over 15 hours of unplanned downtime, versus just six hours of planned downtime.”

Prior to Elekta IntelliMax monitoring, 70 percent of electron guns that reached the end of their lifespan were replaced reactively, after the clinic reported an issue with the part.* This unplanned disruption to clinical service could negatively impact patient care, as treatment appointments required rescheduling on short notice. By virtue of the ability of IntelliMax to pinpoint the future date when an electron gun could experience a service issue, by July 2017, 69 percent of all replacements were done proactively at a time that suited the clinic and when there would not be a negative impact on patient care.

Another notable IntelliMax fix occurred when the hospital’s Elekta Synergy experienced a gantry stop interlock issue during a daily warmup. Reinado was able to remotely restart the gantry and ascertain that the error was due to a faulty printed circuit board (PCB). Reinado was able to return the linac to clinical service and arranged to replace the PCB quickly with a programmed intervention, avoiding system downtime.

Proactive MOSAIQ support via IntelliMax

In 2018, Elekta extended IntelliMax to its MOSAIQ OIS to bring the same proactive support to this Elekta solution. On the strength of Elekta’s recommendation, Hospital Provincial de Castellón became an early adopter of IntelliMax for MOSAIQ, with the aim of ensuring their patient records were always accessible.

“Now, problem resolution is proactive through the Elekta Remote Command Center – and many times before we even know an issue exists.”

“Previously, if we experienced an OIS functionality issue, resolution was reactive,” Santos-Serra says. “We initiated a service call and set up a remote session via WebEx remote desktop access. Although resolution was always fast, we still lost time. Now, problem resolution is proactive through the Elekta Remote Command Center – and many times before we even know an issue exists.”

IntelliMax for MOSAIQ constantly monitors many services and applications that need to be operational for the clinic to fully access its patient records. Elekta software engineers are alerted about issues that arise, often before the clinic is aware, so proactive service can be provided with minimal disruption to clinical activities. In addition, IntelliMax allows them to remotely restart specific applications/services and to download log and configuration files without accessing the system desktop or patient data.

“Having uninterrupted MOSAIQ functionality is really critical for us, because we are a paperless department,” Dr. Santos-Serra says

For its Elekta linacs and MOSAIQ, IntelliMax has been an indispensable resource for Hospital Provincial de Castellón.

“Our close and friendly working relationship with David Reinado over the last four-and-a-half years – and David’s skillful leveraging of IntelliMax – have made any adverse issues increasingly rare,” he says. “We’ve had a similar experience with Elekta’s monitoring of MOSAIQ – often with any OIS issues we are just alerted after the problem has been resolved via IntelliMax. So it’s like there was never an issue to begin with and that keeps our department up and running for our patients.”

The radiotherapy team at Hospital Provincial de Castellón has proven how their use of the latest AI-driven service technology has allowed them to spend even more time delivering the best patient care.

Click here to learn more about IntelliMax.

*Value determined using IntelliMax historical data.

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