There is a big variety of free or commercial DMS in the international market.
After careful consideration,
the authors decided to proceed solely with commercial software.
The main reasons for this decision was a) the intension to perform a more sophisticated data analysis then just simply track radiation dose or comply with regulations and b) the limited experience of the information technology (IT) team related to the subject.
The hospital evaluated extensively 3 DMS for approximately 5 years by direct installation within the hospital and one system indirectly using a link provided by the company.
The DMS were not connected simultaneously to the X-ray machines.
They were evaluated separately to allow time for both the local representatives and regional experts to deal with connection and other issues not related to the DMS or the X-ray machines.
Table 1 lists the DMS evaluated the last 5 years.
Table 1.
DMS software list evaluated by the medical physics team in Konstantopoulio General Hospital,
Athens,
Greece.
DMS,
Company
|
Method
|
X-ray machines
|
Number of examinations
|
Dosewatch,
General Electric
|
Installation
|
CT
|
2451
|
Dose,
Qaelum
|
Installation
|
CT
|
6010
|
Teamplay,
Siemens
|
Installation
|
Radiology
|
100500
|
Radimetrics,
Bayer
|
web link
|
|
|
The evaluation of specific DMS have already been published [4,
5].
Those interested can read those publications for more details.
Further publications are currently being prepared.
Achievements
1.The DMS facilitated the hospital process regarding control of costs from unneeded duplicate tests.
2.They assisted in protocol optimization through all patient data analysis.
3.They helped immensely in setting and continuously review DRLs.
4.The deep involvement of the medical physics team in dosimetric analysis provided an easy,
transparent dosimetric feedback mechanism for the hospital quality management system.
5.Helped in building up a constant patient staff dialogue regarding radiation exposure.
6.Improved patient confidence in the hospital .
7. Specifically,
for those DMS that provided more capabilities such as organ or effective dose (not all manufacturers offer this option),
they allowed a more individual patient-centered approach to dose optimization (Figures 1 and 2)
Challenges
1.
First attempt to install such a software was delayed substantially because of connection and compatibility issues between PACS and software.
The whole procedure lasted for approximately one year.
Finally,
due to unsurpassed difficulties it was decided to connect the software directly to the CT scanner.
The experience gained through this process facilitated immensely next installations.
2.
If there is no PACS/RIS the installation becomes more difficult.
3.
When the DMS was first introduced staff was not very comfortable as the software revealed all their “mistakes” and habits.
Gradually the capabilities of all software was appreciated and fully accepted.
4.
Depending on the DMS capabilities and characteristics,
data analysis should preferably be done by an experienced professional (ideally a medical physicist) in order to take advantage of all capabilities of the software and draw appropriate conclusions.