News | February 27, 2010

ACR Urges Radiation Safety Accreditation for All Healthcare Facilities

Februrary 26, 2010 - The American College of Radiology's (ACR) Task Force on Radiation Dose in Medicine urged Congress to require accreditation of all facilities that bill Medicare for advanced medical imaging and radiation oncology services, including those in hospitals, to reduce the likelihood of adverse patient events and help assure a baseline quality of care nationwide.

Chair of the ACR task force, E. Stephen Amis, M.D., FACR, testified at a House Energy and Commerce Health Subcommittee hearing titled Medical Radiation: An Overview of the Issues. Congress expressed it's surprise that radiation safety, in particular radiation oncology, was under regulated. Currently, accreditation requirements called for by the Medicare Improvements for Patients and Providers Act of 2008, effective Jan. 1, 2012, apply only to nonhospital providers of advanced medical imaging and do not include radiation oncology.

“The problems outlined in recent news reports demonstrate the need for mandatory accreditation in all clinical settings, for all advanced diagnostic imaging services and radiation therapy. Hospitals should be held to the same quality and safety standards as free-standing facilities. Patients have a right to expect the same quality of care regardless of the setting in which they receive it,” said Dr. Amis.

The former ACR Board Chair also cautioned Subcommittee members that any imaging or radiation oncology accrediting body recognized by the Centers for Medicare and Medicaid Services should have a proven track record in the specific fields of radiology and radiation oncology.

“This accreditation must be robust and focus on considerations unique to imaging and radiation therapy, such as image quality, dose monitoring, phantom testing, equipment evaluation, calibration and maintenance, and the qualifications of all personnel involved in the delivery of care in order to be effective,” said Dr. Amis.

He also urged Congress to support a national CT dose registry, such as that being implemented by the ACR.
Dr. Amis stressed that a required dose index registry would be a critical new component that could measure ongoing performance of the accreditation baseline and may have helped identify many of the problems covered in media reports far sooner. He added, "The ACR has been working with industry to develop such a registry but a congressional mandate would aid this process."

Dr. Amis voiced ACR support for HR 3652, the Consistency, Accuracy, Responsibility and Excellence in Medical Imaging and Radiation Therapy (CARE) Act. The bill sets minimum federal standards for training and credentialing of radiation therapists, technicians, and other personnel who perform or plan the technical component of either medical imaging examinations or radiation therapy procedures.

While imaging growth is in line with, or below that of other physician services, appropriate use of imaging can be addressed by expanded use of ACR Appropriateness Criteria, which help physicians prescribe the most appropriate imaging exam for more than 200 clinical conditions (particularly when an imaging exam that does not use radiation may be more appropriate for a given condition), and point of entry physician ordering systems based on this tool, such as the 2010 Medicare pilot project mandated by the Medicare Improvements for Patients and Providers Act of 2008.

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