this site and I think it will be a useful tool
for clinicians to direct them to appropri-
ate exams. I like that each exam gives in-
dications for ordering the exam as well as
listing the protocol, describing the cover-
age on the body and then, too, it gives the
format in how the exam is displayed on
PACS (Figure 2). I also like the section
on the ACR appropriateness for an exam
to direct clinicians to the best exam to
evaluate a specific diagnosis.”
Another component of the utility is
that the user is made aware of the infor-
mation needed by the radiologists, radio-
logic technologists, and schedulers to ac-
curately send and obtain the most useful
test. This has started the process of stan-
dardizing the radiology study ordering
form such that orders are unambiguous,
the proper procedure is requested for a
given diagnosis, and any specific details
such as contrast, patient orientation, or
imaging parameters are addressed. The
utility has been designed to function as a
job aid for all key stakeholders involved
in the radiology exam order process.
The appeal of using a web based utility has been its flexibility and scalability.
Hosting the utility on a single server allows for very tight control over the quality of the content. Changes to the site can
be approved by a group which includes a
radiologist, radiology administrator, and
a medical physicist. In addition, a web
based utility can be implemented over a
network as large as one would like, from
a department in a hospital to a system
of hospitals. By providing a single point
of content manipulation and a stringent
approval process, quality, consistency,
and compliance across the entire hospital
system has been ensured.
For now, the focus has been on CT exams
for both adults and children. However,
time and money are the only obstacles
to extending the scope of the utility to
include other imaging modalities. All of
the data on the utility is generated and
updated with information provided by
the ACR and hospital radiologists as well
as feedback from ordering caregivers and
1. Establishing a comprehensive patient
safety program, including education
about dosing in imaging departments.
2. Create awareness of the potential dangers from diagnostic radiation among
organizational leadership, hospital
staff, and patients.
3. Create adequate awareness among
physicians and other clinicians about
the levels of radiation typically used
and related risks.
4. Provide guidance in the appropriate
use of potentially dangerous procedures and equipment.
5. Provide knowledge regarding typical
6. Create clear protocols that identify the
maximum dose for each type of study.
7. Foster communication among clinicians, medical physicists, technologists,
8. In order to reduce the exposure of
the patient to ionizing radiation, use
other imaging techniques, such as
ultrasound or MRI, whenever these
tests will produce the required diagnostic information at a similar quality level.
9. Ensure all physicians and technologists who prescribe diagnostic radiation or use diagnostic radiation
equipment receive dosing education
and are trained on the specific model
of equipment being used. Institute a
process for annual education, review,
and competency testing.
This second stage of the program will
begin by fleshing out a more comprehensive web resource with content drawn
from reliable and well regarded sources
such as the ACR as well as content specific to Saint Patrick Hospital based on
contributions from the radiologists, radiation safety committee, and other staff.
The expanded web utility will be a one
stop clinical resource to provide information regarding not only our radiology
department but also regarding medical
imaging in general. We will have two major goals. The first goal will be to provide
information that will allow providers to
make more informed imaging decisions
and thus maximize the medical benefit of
an imaging study while minimizing the
risks and expenses to patients. The second goal will be to provide patients with
a convenient source of information that
will answer any questions or concerns
they may have. A computer kiosk hosting this utility will be available in all the
radiology waiting areas.
The appeal of using a web based utility has been its flexibility
and scalability. Hosting the utility on a single server allows
for very tight control over the quality of the content.
Although quantifiable data has not yet
been abstracted based on the effects of
the web utility, it is our hope that since
implementing this program patient