Radiation Dose Profile - Brief Proposal: Difference between revisions

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==2. The Problem==
==2. The Problem==


''<Summarize the integration problem. What doesn’t work, or what needs to work.>''
Tracking radiation dose delivered to patients for medical purposes is gathering increasing attention from professional societies and regulatory groups.  Publications include: [http://eur-lex.europa.eu/smartapi/cgi/sga_doc?smartapi!celexplus!prod!DocNumber&lg=en&type_doc=Directive&an_doc=1997&nu_doc=43 European directive Euratom 97/43], [http://www.acr.org/SecondaryMainMenuCategories/quality_safety/white_paper_dose.aspx ACR Dose Whitepaper] and some Japanese regulations).  


Tracking radiation dose delivered to patients for medical purposes is gathering increasing attention from both professional groups ([http://www.acr.org/SecondaryMainMenuCategories/quality_safety/white_paper_dose.aspx ACR Dose Whitepaper]) and regulatory groups ([http://eur-lex.europa.eu/smartapi/cgi/sga_doc?smartapi!celexplus!prod!DocNumber&lg=en&type_doc=Directive&an_doc=1997&nu_doc=43 European directive Euratom 97/43], Japanese regulations).  
Many such groups have expressed a desire to establish standards of practice based first on a quantitative understanding of current practice, however they have found it prohibitively difficult to collect such data.
Needs have been expressed to track both dose to individual patients and to assemble population data.


Such tracking requires coordinated use of standard protocols by the multiple systems that schedule studies (RIS), administer radiation (modalities, and therapy systems), and store and report the results (PACS?, HIS?, EHR?), possibly across multiple institutions.  There have also been calls for collecting population data in national registries.
In most of the world, although it should be, it is not possible to do things like:
:* view the dose a patient (or particuar organs) received for a certain exam, hospital stay or course of treatment
:* view a patients cumulative dose history
:* compute the "dose profile" for a certain hospital or region
:* compute the "dose profile" for a certain pathology
:* compare "dose profiles" against other sites/regions, against local policy targets or against standards of practice


While standards exist for encoding such information (DICOM SR Dose objects, some attributes in DICOM IOD’s and MPPS), the work to knit the pieces together into a big picture has not been done.  There is also the usual chicken-and-egg problem of getting systems to produce and consume the data.
Standards related to dose tracking exist (DICOM SR Dose objects, DICOM IOD’s attributes, MPPS attributes and possibly others in radiotherapy and nuclear medicine),  
 
The problem is that dose tracking has not been widely deployed due to:
:* difficulty coordinating the roles of the different systems involved (which actors should do what)
:* difficulty coordinating tracking across multiple departments and multiple institutions
:* the need to converge on one of the available standard approaches
:* a chicken-egg situation between the dose record producers, the dose record recievers and the dose record consumers
 
These are, of course, many of the typical problems that IHE is used to addressing.


==3. Key Use Case==
==3. Key Use Case==

Revision as of 18:58, 20 July 2007

IHE Profile Proposal (Brief)

1. Proposed Profile: Radiation Dose Profile

  • Proposal Editor: Joel Chabriais/Bernard Aubert/Kevin O'Donnell
  • Date: N/A (Wiki keeps history)
  • Version: N/A (Wiki keeps history)
  • Domain: Radiology (SFR, ACR, AAPM, IRSN, RSNA, FDA)

2. The Problem

Tracking radiation dose delivered to patients for medical purposes is gathering increasing attention from professional societies and regulatory groups. Publications include: European directive Euratom 97/43, ACR Dose Whitepaper and some Japanese regulations).

Many such groups have expressed a desire to establish standards of practice based first on a quantitative understanding of current practice, however they have found it prohibitively difficult to collect such data. Needs have been expressed to track both dose to individual patients and to assemble population data.

In most of the world, although it should be, it is not possible to do things like:

  • view the dose a patient (or particuar organs) received for a certain exam, hospital stay or course of treatment
  • view a patients cumulative dose history
  • compute the "dose profile" for a certain hospital or region
  • compute the "dose profile" for a certain pathology
  • compare "dose profiles" against other sites/regions, against local policy targets or against standards of practice

Standards related to dose tracking exist (DICOM SR Dose objects, DICOM IOD’s attributes, MPPS attributes and possibly others in radiotherapy and nuclear medicine),

The problem is that dose tracking has not been widely deployed due to:

  • difficulty coordinating the roles of the different systems involved (which actors should do what)
  • difficulty coordinating tracking across multiple departments and multiple institutions
  • the need to converge on one of the available standard approaches
  • a chicken-egg situation between the dose record producers, the dose record recievers and the dose record consumers

These are, of course, many of the typical problems that IHE is used to addressing.

3. Key Use Case

<Describe a short use case scenario from the user perspective. The use case should demonstrate the integration/workflow problem. Feel free to add a second use case scenario demonstrating how it “should” work. Try to indicate the people/systems, the tasks they are doing, the information they need, and hopefully where the information should come from.>


4. Standards & Systems

<List existing systems that are/could be involved in the problem/solution.>

<If known, list standards which might be relevant to the solution>


5. Discussion

<If possible, indicate why IHE would be a good venue to solve the problem and what you think IHE should do to solve it.>

<Try to keep the proposal to 1 or at most 2 pages>

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