Templates and existing elements and models for implementation of patient exposure tracking

Abstract

There is wide interest currently in patient exposure tracking. This paper provides templates for implementation of tracking at the practice (hospital) level, multi-practice level, national level and international level. It provides suggestions for implementation in less-resourced countries. It includes elements such as patient identifier, dose quantities that should be covered and how to make sense from dose figures, availability of digital imaging and communications in medicine files with dose information or structured dose reports and capabilities of picture archiving and communication system (PACS). While tracking at several hospitals in a country connected by PACS and nationwide PACS is also a reality, tracking at the international level is currently a challenge. Guidance provided in this paper will facilitate its implementation at all levels.

Patient radiation exposure and dose tracking: a perspective

“…Templates for use by countries at different levels of development have been provided. 4 Worldwide needs were assessed, and results have been published. 9 Furthermore, a survey of availability and use of unique patient identification numbers (ID) in 40 countries around the world was studied.…”

“…A paper from our group has demonstrated how dose information of an individual patient from different imaging studies was useful in identifying scope for optimization. 8 In a previous paper, 4 we have provided a comprehensive list of potential benefits from patient exposure tracking, which is reproduced here in Table 1. These benefits include those to patients, to health-care providers who refer patients and who perform imaging studies, and to policymakers, regulators, and researchers.…”

“…4 We deliberated on various levels, such as practice, multipractice, national, and international. A template for less-resourced countries was also addressed.…”

“…As a result, physicians are left with decision-making based on gut feelings, which explains the response to the survey among referrers. 4 There is an urgent need to provide guidelines and clarity in standards to help in such situations.…”

“…When the dose of each examination is also recorded, then this is termed dose tracking. 4 In addition to overarching questions such as "Why track, what to track, and how to track?," this paper discusses themes, such as attitudes toward tracking, review of practices in large parts of the world, description of various elements for exposure and dose tracking, how to use the information available from tracking, templates for implementation of tracking at different levels of health care, the role of picture archiving and communication systems (PACS) and eHealth, the role of tracking in justification and optimization of protection, comments on cumulative dose, how referrers can use this information, what dose indices to track, the role of smart cards, current provisions in international standards, and future actions.…”