Dose control : System queries multiple facilities to generate lists of CT priors

November 29, 2009

A system that counts the number of CT exams by body part and date and alerts clinicians when they order more CT studies has been implemented at Brown Alpert Medical School in Rhode Island.

A system that counts the number of CT exams by body part and date and alerts clinicians when they order more CT studies has been implemented at Brown Alpert Medical School in Rhode Island.

Described Sunday in a clinical session, the system probes databases from three facilities to generate alerts to physicians that patients could be exposed to too much radiation from CT scans, said principal researcher Dr. William Mayo-Smith.

The facilities have been tracking CT exams since 2001, Mayo-Smith said. Working with their IT team, the researchers developed a system that queries databases at three facilities and generates a list of CT exams that have been conducted since 2001 and in the last 12 months whenever there's an electronic order request. The alerts are generated when there are five or more scans in either time frame for patients 50 years of age and younger.

The reason for the system is the soaring dose exposure from CT exams. Today CT scans account for 10% of radiology volume, but 75% of the effective dose, Mayo-Smith said.

The system was implemented in 2008. Between January and September of this year 16,000 orders for CT came in to the facilities, and the warning screen was displayed 14% of the time, Mayo-Smith said. Among emergency room physicians there were 21,000 CT scans and 28% of them generated searches for prior CT data.

The researchers are not able to say at this point how the alerts change patient management, Mayo-Smith said.

Facilities covered by the system are Rhode Island Hospital, a 750-bed teaching facility; Miriam Hospital, a 250-bed facility with some teaching responsibilities; and Newport Hospital, a 130-bed facility with no teaching responsibilities.