Radiation tracking: A really good use for personal health records

Mainstream medicine is slowly coming around to the realization that patients are getting too much radiation from diagnostic imaging. I’ve been writing about it for years as the research has been published, and have been a fan of the Image Gently initiative, which seeks to reduce unnecessary pediatric radiation exposure.

An article in last month’s New England Journal of Medicine (Exposure to Low-Dose Ionizing Radiation from Medical Imaging Procedures), which documented some disturbingly high exposures among patients, may be a catalyst for broader action.

According to the Boston Globe (Is all that scanning putting us at risk?) the Brigham and Women’s Hospital in Boston is planning to start tracking radiation exposure and reporting it to physicians, to raise awareness about exposure levels. They’re going back for 22 years of history, which is important because radiation doses are cumulative. I applaud the Brigham effort, but it has some real limitations. The biggest addressable problem is that it only captures imaging done at the Brigham. It might be expanded to include the whole of Partners HealthCare. Still that doesn’t really help patients who’ve lived in multiple places over their lifetime or have imaging done in multiple systems.

Personal health records are a great place to store information on radiation exposure. They’re connected to the person not the provider or payer, and so at least in theory could record all of a patient’s exposures over the lifetime. Even better are PHRs that store radiology reports and even the images themselves. This can help avoid unneeded rescans that are done when previous information isn’t readily available.

Imaging has been very lucrative for providers, which is one reason attention to radiation exposure hasn’t come to the fore. In any case tracking radiation doesn’t mean the end of imaging. Popular modalities including MRI and ultrasound don’t utilize radiation at all.

September 15, 2009

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