Case Study - Hahnemann Univeristy Hospital

November 24, 2014
CASE STUDY
Preparing for Federal and State Dose Regulations
How Hahnemann University Hospital is Tackling the Challenge
Hahnemann University
Hospital, part of Tenet
Health System, located
in Center City
Philadelphia is a 500bed tertiary academic
center that serves as a
Level 1 trauma center
for the surrounding
community.
A Q&A with Hahnemann University Hospital’s former Director of
Radiology, Christopher Lamalfa
Many healthcare organizations are currently evaluating how to comply with upcoming Joint
Commission changes coming in July of 2015 specific to dose. As an organization that is
already compliant, can you describe key drivers to begin the process and where you started?
In response to the 2010 implementation of California legislation SB 1237 which requires recording of
dose in a patient’s record and reporting when it exceeds certain thresholds, Hahnemann University
Hospital decided to take the necessary steps to prepare and be compliant before a potential
national rollout of the law to better manage risk and patient safety. It was during this time we began
to evaluate how technology could help us in the process.
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November 24, 2014
What were the requirements in selecting a technology vendor to
prepare for dose transparency, and why were they important to
your organization?
Key criteria for a technology partner included ease of implementation,
ease of system use, and minimal impact to current workflow. These
were important because we did not want to conduct a major IT effort
to begin the path towards dose transparency. We could not afford to
have departmental downtime with a lengthy implementation of the
system, nor could we afford to spend time mapping existing protocols
to get started, or be required to impact our existing workflow. We
looked for a solution that was simple to get up and running and was
user friendly once installed. All of these factors led to the selection of
Imalogix™ in 2012.
Can you describe the installation process and usability of the
system?
The Joint Commission
has delayed the
revised requirements
that address risks
associated with
diagnostics imaging
for accredited
hospitals, critical
access hospitals, and
ambulatory care
organizations that
provide diagnostic
imaging services.
These requirements
specifically address
patient radiation dose
documentation. The
revised requirement of
implementation of
these changes has
moved from July 1,
2014 to July 2015.
At Hahnemann University Hospital it took less than a day to connect
all of the scanners and once installed data collection began right away. Once the system was up
and running we didn’t have to spend time learning software—it really is just point and click. We can
view information from the enterprise to department to scanner to patient. Reports are easily
customized and simple to run which allows us to easily run macro level reports on dose estimates
like DLP and quickly change to SSDE (Size Specific Dose Estimate) as an example. Once installed
we immediately were able to focus on patient and dose safety, and how we could improve our
operations. “We could not
afford to have
departmental
downtime with a
lengthy
implementation”
What has been the benefit of installing the Imalogix™ system
and how has access to new data impacted your operations?
Hahnemann University Hospital now has a true blue way to monitor
dose, make necessary adjustment and monitor if those adjustments
are working or not working. In addition, we can complete a root
cause analysis for cases where we have had reoccurring system
alerts to determine if there is a common denominator like a
technologist, protocol, or scanner that is causing the issue and
make the necessary operational adjustments. - CHRISTOPHER LAMALFA
A specific example is that we had an instance where Imalogix™
identified a protocol that wasn’t performing well. It was clear that the issue was not with the
technologist performing the studies, rather an issue on one particular CT scanner and the definition
of a specific abdominal and pelvis urology protocol. We were able to make adjustments to the
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November 24, 2014
protocol to reduce the dose, and in turn increase patient safety. We would
have never known there was an issue before Imalogix™. Currently you are monitoring CT and mammography scanners only,
what are you plans for other modalities in the future? Why is this
important?
Hahnemann
University Hospital’s
Department of
Radiologic Sciences
is accredited by the
ACR in: Computed
Tomography,
Magnetic Resonance
Imaging, Ultrasound
and Vascular, Nuclear
Medicine. The ACR
has designated
Hahnemann as a
Breast Imaging
Center of Excellence
with accreditation in:
Breast Magnetic
Resonance Imaging,
Breast Ultrasound,
Digital Mammography
and Stereotactic
Breast Biopsy.
Imalogix™
For more information
on Imalogix™, please
visit our website at
www.imalogix.com or
email
imalogix@mihllc.com.
We are developing a radiation safety committee specific to radiology to
look holistically at our protocols, how we are performing the studies and
what we are doing to keep dose to a minimum. We are preparing to track
the holistic dose story of the patient
once he or she enters the health
system for a visit or series of visits
across all dose producing imaging
modalities. This is important to us at
Hahnemann University Hospital
because we anticipate future Joint
Commission and CMS regulation
changes and we want to be prepared. What advice do you have for
hospitals that are moving towards
dose monitoring?
“We were able to
make
adjustments to
the protocol to
reduce the dose,
and in turn
increase patient
safety. We would
have never
known there was
an issue before
Imalogix™.”
Don’t wait because you are going to
need time to build your dose history
and to build your reports, so by the
time year 2015 and 2016 comes, you
have data for CMS to show how you
- CHRISTOPHER LAMALFA
are tracking dose, and what
corrections you are making. Without a technology there is no process to
do this effectively or efficiently. Furthermore with the data provided by
systems like Imalogix™, organizations will be able to have a systematic
way to reduce dose exposures, improve overall operational performance,
and maintain margins by avoiding financial penalties from federal or state
regulating bodies.
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