Promoting Patient Health, Safety through Standards

November 11, 2014
Gail Rodriguez, PhD

With the advancement of medical imaging technology comes the need for updated safeguards.

Advanced medical imaging technologies have revolutionized health care, giving doctors the ability to detect and diagnose cancer and other diseases earlier than ever before when they can be treated more effectively. As technology advances, the imaging industry likewise develops safeguards to protect patients and promote the highest quality care. We do this in part by creating and implementing standards. The National Electrical Manufacturers Association (NEMA) and Medical Imaging & Technology Alliance (MITA) have taken the lead to create rigorous standards and encourage their adoption across the industry.

About Standards
The most obvious and essential universal standard today is how time is measured. Its units - hours, minutes and seconds-promote consistency and order. Another example is the way light bulbs fit into lamps; companies design and manufacture bulbs that comply with standards to ensure compatibility. Similarly, clearly defined technical standards offer ways to measure imaging and radiation therapy (RT) equipment performance. These standards improve patient safety and create efficiencies in the delivery of care. Developed by leading imaging manufacturers, with input from other experts across the field, standards assure patient access to the latest medical advances.

The Evolution of Imaging Standards
Safe and effective protocols for imaging technologies are imperative, and standards help reinforce their integrity. For example, computed tomography (CT) technologists must have all the necessary tools to achieve image quality and adjust dose levels appropriately, based on patients’ individual needs when changing or performing CT protocols.

Guided by these principles, MITA created XR-29 “Standard Attributes on CT Equipment Related to Dose Optimization and Management”, also known as MITA Smart Dose CT. This standard specifies four elements - two existing standards and two product features - that promote dose optimization.

The first component of MITA Smart Dose CT is DICOM Radiation Dose Structured Reporting. The existing DICOM Standard specifies the recording of dose-related data in a standardized electronic format. This information can be included in the patient record, and can facilitate an institution’s dose management and quality assurance. CT Dose Check (XR-25) is a standard that includes dose notifications and dose alerts to inform technologists and physicians when radiation dose exceeds established thresholds.

The two product features of MITA Smart Dose CT are protocols and Automatic Exposure Control (AEC). Preloaded pediatric and adult reference protocols serve as a baseline for a variety of clinical tasks. AEC automatically adjusts the amount of radiation used based on the size, shape, and composition of the patient in order to achieve a specified level of image quality.

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Once a standard has been adopted, compliance is critical to ensuring its effectiveness. In recognition of the substantial public health benefit associated with the application of dose optimization technologies, Congress voted in March 2014 to promote the adoption of MITA Smart Dose CT in the SGR patch legislation. Beginning in January 2016, Medicare will reimburse less for CT scans that are performed on non-compliant equipment: a 5% reduction in reimbursement in 2016, and 15% reduction starting in January 2017. The reductions apply to the hospital outpatient setting, as well as services billed under the physician fee schedule on traditional and hybrid scanners. Visit MITA’s website for additional information.

Fortunately, the majority of CT equipment is already upgraded or can be upgraded to comply with MITA Smart Dose CT. MITA’s members who manufacture CT equipment are working with hospitals and providers around the United States to ensure their equipment meets the requirements.

Appropriate use of advanced medical imaging technologies, in accordance with industry standards, will improve patient health and safety and decrease long-term health care costs. Standards streamline the process from introduction to implementation of new, innovative, life-saving imaging technologies while emphasizing safety for the protection of patients. NEMA and MITA are committed to the ongoing development of new standards and to their adoption to ensure patients have access to the safest, most innovative technologies available.

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