by
Lauren Dubinsky, Senior Reporter | September 23, 2016
From the September 2016 issue of HealthCare Business News magazine
Previously, Golkin would identify the protocols that were out of line and put them in an Excel spreadsheet. She would then go to the PACS system to look at the images and then to the EMR system to find out the patient’s BMI. That process took her a week. But Well-Star recently implemented Philips Healthcare’s DoseWise dose management program and she’s now able to do that in one day. The program automatically separates the exams that exceed the set dose level and places them in a notification category. Golkin then retrieves patient information and reviews the exams.
The American College of Radiology defines the average patient as 5-foot-7 and 154 pounds, but that is not consistent with the patient population in some states. Golkin decided to develop appropriate reference levels for patients with higher BMIs at WellStar. “This regulation has affected CT more than any other mandates in the last decade,” says Golkin. “But the point of it is not that it makes you in compliance, it’s that it really does help the patients.”
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GE Healthcare partnered with the University of Wisconsin School of Medicine and Public Health in 2012 to reduce CT dose, acquire more clinically useful images and lower the amount of repeat scans. In order to do that, they developed a set of protocols that cover most clinical indications including neuro, MDK, chest, body, vascular and pediatric.
The GE engineers and hospital staff adjusted the type, amount and timing of oral and intravenous contrast, and also modified patient positioning and scan reconstruction parameters to optimize each protocol. At many hospitals, the technologist has to arbitrarily modify the protocol based on the patient’s weight or BMI. With UW’s new protocols, the technologist chooses the protocol that’s tailored for the patient’s body size and proceeds with the scan. Over the past few years, the focus in CT has shifted from increasing the number of slices and getting better resolution to ensuring the diagnosis is accurate and done with the appropriate dose.
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