IEEE - USA Position Statement: Documenting Cumulative Radiation Exposure in the EHR

submitted by Thomas Jepsen

IEEE-USA believes that maintaining an accurate record of a patient’s cumulative exposure to various types of radiation is an important component of a patient’s health profile, and can play a significant role in making healthcare decisions.  Radiation exposure can come from a number of sources, both natural and manmade, over the lifetime of the individual;  medical procedures such as X-rays, Computed Tomography (CT)  scans, and isotope radiation therapy contribute significant radiation  dosages. Therefore, it is essential that a means be provided to document aggregate exposure from multiple sources in a format that is meaningful to healthcare practitioners.  In support these objectives, IEEE-USA recommends the following:

1)Health Level Seven (HL7) should add the appropriate "dose object" radiation parameters, as defined in the IHE Radiology Technical Framework Supplement, Radiation Exposure Monitoring (REM), to HL7/CDA format longitudinal electronic health records (EHRs) in order to create a longitudinal record of a patient's exposure to radiation as a result of medical procedures.

2)The Office of the National Coordinator for Health Information Technology (ONCHIT) should make radiation dose monitoring a part of meaningful use criteria for EHRs.

3)State legislatures should draft legislation that monitors and regulates radiation exposure from medical procedures.

4)The American College of Radiologists (ACR) should continue their efforts to establish a "dose registry" of anonymized patient radiation dose monitoring information to enable further research on the impact of various levels of radiation on patient health.

5)Integrating the Healthcare Enterprise (IHE) should continue working to  include nuclear medicine (Positron Emission Tomography or PET scans, isotope therapy) in the Radiation Exposure Monitoring (REM) Profile.

6)Additional  study is needed to determine the effects of naturally occurring background radiation and nuclear accidents on long term patient health.

(Complete Report in attachment below)