Two phases of upcoming radiation dosage standards changes will require that healthcare organizations ensure that imaging services are up to date and sufficiently address quality and safety. As the Joint Commission’s July 1 deadline approaches, radiation dose tracking continues to be a hot topic in healthcare. This deadline is spurring a number of conversations about topics ranging from lifetime levels of radiation exposure to training of medical students, from state laws to technical solutions.
Here’s what healthcare organizations should know about where the conversation is heading.
- Act on Data. First of all, it’s a challenge to estimate exact radiation doses. Different tests emit various amounts of radiation, and radiation absorption is determined by what body part is exposed and the age and size of the patient. These factors make it tough to accurately estimate radiation exposure. Physicians who are given a strong education about radiation dosage estimates and the costs of tests are critical to changing the norm when it comes to medical imaging radiation dosage.
A study from the journal Medical Care found that referring physicians who were taught about radiation dosage and medical imaging exam costs were more likely to consider changing the tests they ordered than physicians who lacked that information. In addition, radiation exposure occurs naturally from our environment, as we mentioned in our recent blog about lifetime limits to radiation exposure. Working with referring physicians and improving awareness of radiation, both naturally occurring and from testing, is key to knowing when to alter ordered tests.
- Improve Training of Medical Students. Medical residents have solid background knowledge about radiation dose exposure effects, but a recent study found that they lag behind when it comes to detailed knowledge in specific areas. The study from Emory University found that although 95 percent of residents believed there is a link between radiation exposure and cancer, only 10 percent could accurately pinpoint the radiation dose that would be associated with a fetus brain malformation in pregnancy, for example. Radiologist Resident Gelareh Sadigh, head researcher of the study, said that all residents, across physician specialties, should receive standardized basic radiation dosage safety training.
- Consider State Laws. Some states are introducing legislation to track patients’ radiation exposure. California, Texas and Connecticut currently have laws in place; California’s version requires medical imaging facilities to document radiation dose on every patient record, has specific maximum dosage thresholds set in place, and mandates that any time a threshold is passed it must be reported within 15 business days. Now the Joint Commission’s upcoming deadline will further determine how healthcare organizations will be required to implement systems to track.
- Make It a Group Effort. The number of stand-alone medical imaging facilities means that more patients will undergo testing, and be exposed to radiation, at multiple locations. Accurately tracking patients’ exposure to radiation is going to require a concerted, cohesive group effort between various organizations and should also include the patient and his or her referring physician. A study published in the journal Cancer found that cancer patients who were actively involved in shared decision making about their medical care had higher rates of satisfaction and lower rates of depression, anxiety and fatigue.
Healthcare organizations will need to determine strategies for accurately sharing data, keeping patients’ EHRs up to date, and tracking radiation dosage levels. Some healthcare organizations are implementing internal programs to capture data on radiation exposure in their efforts to lower radiation dosage levels. One such program at Emory Radiology has reduced doses by between 30 to 50 percent.
- Determine Technical Solutions. Medical imaging software that helps users collect patient data, including radiation exposure, is an important tool in the efforts to protect patients from high doses of radiation. Software solutions that allow information to be shared between facilities and is accessible anywhere, anytime are available. RIS/PACS solutions are critical components for radiology departments and medical imaging facilities of various sizes and configurations. They help improve efficiency and communication, may have web-based access to patient data and reports, and integrate with patients’ EHRs. They facilitate the sharing of radiology dosage information, to help ensure that healthcare organizations are meeting their compliance goals and improving patient safety.
As the conversation continues, groups are implementing new standards and tracking processes. From residency programs to state legislatures, at medical facilities and physician organizations, better ways to track data are being considered. Whether your organization is using a RIS system or various software solutions, now is the time to work together to discuss, analyze and implement ways to track radiation dosage in the ongoing effort to help maximize patient safety efforts.
If you are preparing for the Joint Commission standards, we can help. Download our paper now to learn how McKesson can help you with the Joint Commission standards. To stay up to date on the radiation exposure conversation and other industry news, subscribe to the Medical Imaging Talk blog by filling out the form on the top of this page on the right.