DOSE MANAGEMENT SYSTEMS
A dose management system (DMS) is an IT solution designed to automatically collect and analyze patient radiation exposure data across multi-facility,
multi-modality,
and multi-vendor imaging environments.
DMSs enable healthcare professionals to monitor the radiation exposure of their patients,
evaluate their practices and make improvements to optimize the benefits from the exposure.
They help to:
- Document dose
- Set Dose Reference Levels
- Monitor machine performance
- Optimize systems at user level
- Manage protocols
- Identify outliers
They also provide reporting capabilities for radiation safety personnel,
internal stakeholders,
patients,
external governing bodies,
and regulatory authorities.
By comparing current performances against industry guidelines and best/better practices, DMSs can help users to balance dose management priorities throughout the hospital or across the entire healthcare system.
DMSs also compare machine performance to existing DRLs that can lead to identifying possible areas for improvement such as personnel training needs,
and equipment degradation or the need for equipment maintenance. DMSs tracking,
monitoring,
and analytics software can be integrated with other systems such as EHR,
PACS,
and RIS to monitor,
track,
and archive the patient dose information and to improve patient safety.
Market: The DMSs market is estimated to grow considerably in the next few years. The factors driving the market are:
- Desire for complete patient histories in the electronic health record
- Access to patient histories through health information exchange
- Increasing use of radiological equipment for diagnosis
In 2016,
hospitals accounted for the largest share of the global DMSs market,
followed by ambulatory care settings and research institutions & academic medical centers. North America was the major market,
followed by Europe and Asia-Pacific.
Connected devices: COCIR recently started to collect data on devices connected to DMS in several European Countries with a plan to expand the geographies and increase the granularity of data.
The 2018 survey showed that up to 8000 radiological devices are connected to DMSs provided by COCIR Members (not all radiological modalities are covered yet).
The effort would allow in the future to estimate the percentage of radiological devices connected to DMS over the installed base.
Obstacles to adoption: The following factors have been identified as obstacles for a faster adoption of DMSs:
- Budget constraints
- Lack of understanding on which elements to consider when selecting a DMS,
from the myriads of products available,
that will best meet the institution's needs
- Lack of in-house education and training on radiation dose management
Elements that could foster the adoption of DMSs in an institution include:
- Understanding how to extract meaningful information from collected data
- Understanding how to integrate findings from data analyses into existing radiation protection programs
- Understanding how a comprehensive strategy on the use of the data can aid with machine and patient dose management
Future developments: Today,
dose tracking is a retrospective activity as it can only monitor events as they happen and shed light on them after the fact.
In a near future the technology may evolve into a predictive analytic tool.
The technology is also evolving to enable the user to see what imaging a patient has had before the next study is ordered,
meaning at the point of order entry.
This capability would complete the IAEA requirements for justification and optimization of all x-ray exams.
Having the capability to see a patient's exposure history prior to order entry,
would allow the ordering clinician to decide whether a prior exam can be used to provide the diagnostic information,
or whether a new exam is justified,
or if a non-ionizing radiation diagnostic exam should be used instead. The optimization requirement is already satisfied if the institution has made use of a DMS to assess and reduce x-ray exam exposure.