Balancing Radiation Risks, Benefits, and Quality

Janice Simmons, for HealthLeaders Media , March 4, 2010

The group, the American Society for Radiation Oncology, or ASTRO, issued a six point plan designed to improve safety and quality and reduce the chances of medical errors. The group also said it is pressing for federal legislation to require national standards for radiation therapy treatment teams.

Better record keeping. Earlier this year, the National Institutes of Health announced that all of its physicians should begin recording radiation doses for patients in their medical records.

All vendors that sell imaging equipment to the clinical center will be required to "provide a routine means for radiation dose exposure to be recorded in the electronic medical record," said David A. Bluemke, MD, the study's lead author and director of Radiology and Imaging Sciences at the Clinical Center.

In addition, radiology at NIH also will require that vendors ensure radiation exposure can be tracked by patients in their own personal health records. This approach is consistent with the American College of Radiology's and Radiological Society of North America's stated recommendation that "patients should keep a record of their X-ray history."

Provider assistance. As Massachusetts General Hospital in Boston has found, electronic medical records can be used to help providers when ordering scans. Here, when a provider orders a test, he or she will get an answer back: If the test is questionable or another test might be more appropriate, physicians or other providers will get a yellow cautionary light. If a scan isn't recommended, it comes up red.

Industry alerts. The Medical Imaging & Technology Alliance (MITA) said last week that manufacturers will begin adding a color coded warning system to give healthcare providers clear warning when they are doing scans that give patients potentially dangerous doses of radiation.

The changes, which would be phased in starting this year, would require the machines to provide a yellow alert screen when the dose is higher than anticipated. The scanning devices would display a red alert warning when a patient is about to be given a dangerous dose of radiation. The system would also allow hospitals and imaging centers to set their machines to prevent these scans from happening.

Radiation and radiology have been around for so many years that we rarely give a second thought to issues such as safety and appropriateness. But for our health's sake, perhaps we should.

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Janice Simmons is a senior editor and Washington, DC, correspondent for HealthLeaders Media Online. She can be reached at

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