Public radiation exposure has increased significantly in the last 30 years. According to a 2006 report from the National Council on Radiation Protection and Measurements (NCRP), medical imaging accounted for nearly half of all public exposure that year. In response to these figures and growing concerns around general best practices in radiation safety, a number of regulatory and legislative efforts have formed to raise awareness and address the risks of radiation exposure, and develop protocols to ensure physician and patient safety. From a regulatory standpoint, the Joint Commission has created new standards that require hospitals to abide by more stringent patient dose monitoring protocols and there are new state regulations being adopted locally. Additionally, CMS’s new payment program, MACRA, includes dose management-related requirements that clinicians must follow for more accurate and complete reimbursement. While these are all very positive signs for the industry, they do bring significant challenges for health systems across the country.
In a previous blog, I talked about striking a balance between dose and benefit to give clinicians the best possible diagnostic information at the lowest possible dose. This is a good practice that still rings true, but it really takes a combination of determined people and a strong informatics infrastructure to truly make radiation dose management a success. For many radiologic technologists today, radiation exposure documentation is a time consuming, manual process largely based on EMR reports. In this ecosystem, while pinpointing individual scanner and location issues is doable, comparison and tracking for systemwide improvements proves to be very challenging, if not impossible.
The reality is that individual facilities still have a lot of work to do to properly design and implement a radiation exposure monitoring effort. While the recent evolution of radiation dose tracking software applications, such as Philips’ DoseWise Portal, are helping with this, there is a growing demand for increased connectivity and interoperability of these solutions within the hospital IT network, which will allow clinicians to make informed decisions faster and easier without needing to consult several different sources. For example, interaction with Electronic Medical Record systems will allow dose tracking solutions to update important patient demographics such as age and weight – critical for the analysis of dose optimization. Additionally, interoperability with PACS systems allow clinicians to identify dose down to the individual exam or cumulative level directly from a PACS image – a huge jump forward in patient care.
As a leader in imaging informatics, Philips has been on the ground with interventional radiology departments, working together to develop and maintain successful radiation dose monitoring programs that are designed to be effective, safe and compliant over the long term. It is no longer enough to collect and understand your data – the real benefit comes from what people decide to do with it. It is clear that healthcare providers need new tools for managing this data and the challenge for manufacturers is to piece these solutions together to create a simple solution for the customer. Through this, clinicians will be able to access more patient information and more easily interpret data across different modalities to assess cumulative exposure and determine when and where scanning protocols should be modified.
As the industry continues to focus on the important issue of radiation dose management, informatics solutions with interoperability across the hospital IT network will take center stage as departments look to equip their clinicians with technology that allows them to make data-driven decisions with more ease and confidence. Meaningful change in dose management is only now hitting the tip of the iceberg – as more hospitals adopt these strategies and invest in this technology in the future, the utilization of appropriate dose management techniques will no longer seem grandiose, but rather part and parcel of a hospital’s radiation safety program.