William W. Boonn MD, Presenter: Principal, iVirtuoso, Inc Stockholder, iVirtuoso, Inc Principal, Montage Healthcare Solutions, Inc Stockholder, Montage Healthcare Solutions, Inc

Angela M. Mills MD, Abstract Co-Author: Nothing to Disclose

Andrew D.A. Maidment PhD, Abstract Co-Author: Research support, Hologic, Inc, Bedford, MA Consultant, Real-Time Tomography, LLC

Stefan L. Zimmerman MD, Abstract Co-Author: Nothing to Disclose

Tessa S. Cook MD, PhD, Abstract Co-Author: Nothing to Disclose

Woojin Kim MD, Abstract Co-Author: Principal, Montage Healthcare Solutions, Inc Consultant, Amirsys, Inc Principal, iVirtuoso, Inc

CT radiation dose is undergoing scrutiny by regulatory bodies as well as the lay press with increased pressure to monitor and manage patient exposure. We have recently proposed tools to track and analyze CT dose within a department and to facilitate participation with ACR dose registries. This system will evaluate measures within a radiology department including the scanners, the scan protocols, the technologists, the radiologists, and trainees. This project aims to expand the scope of CT dose management to the ordering physician.

We demonstrate an integration of CT radiation dose into an existing Electronic Medical Record (EMR) and computer physician order entry (CPOE) system to aid in decision support at the time of order entry. This integration interfaces with an existing CT radiation dose extraction and analysis pipeline to provide cumulative CT radiation dose for each patient when a new CT examination is ordered. Ordering physicians are provided total cumulative CT dose based on information present in the dose series of all prior CT exams, an estimate of the additional dose the patient will receive with the ordered CT examination based on institutional as well as published values, as well as reference values for radiation dose including background exposure and occupational safety limits. The data is presented graphically as well as in table format to provide better temporal information on when prior CT examinations were ordered and at what frequency.

There is increasing awareness and vigilance for decreasing radiation dose within our radiology department, particularly after the implementation of our CT dose reporting and analysis pipeline. This project extends that awareness beyond Radiology and helps to provide relevant information about a patient's prior CT dose real-time at the point of order entry to guide in decision support.

Integration of CT dose information into an EMR and CPOE can facilitate order entry decision support.

Boonn, W, Mills, A, Maidment, A, Zimmerman, S, Cook, T, Kim, W, Integration of CT Radiation Dose Reporting into an EMR and CPOE System for Order Entry Decision Support.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9006151.html