Second defense: Eliminating unnecessary scans
The Radiology Group also works to educate referring physicians, who often do not know the correct type of study to order.
“They’ll do the CT scan and invariably the patient is going to need an MRI or another type of study,” Lalaji says.
So his company provides physicians with order guidelines that list common symptoms and the best test for each symptom.
At Brigham and Women’s, radiologists were able to limit unnecessary scans by using decision-support software that warned physicians if the test they were ordering for a patient was recently done or if the yield of the diagnostic information was likely to be low and, therefore, the test useless. The software would then steer the physicians to an equivalent imaging test that doesn’t use ionizing radiation, like ultrasounds and MRIs.
By using this software, Brigham and Women’s decreased CT-scan utilization by 15% over the past three years, well below the industry average increase in CT scan use of 5% to 8%, Seltzer says.
Third defense: Radiation-reducing technology
“Intra-procedurally, we’ve tried to capitalize on everything that the equipment manufacturers have been able to deliver, and there are a handful of technological innovations that help minimize radiation exposure,” Seltzer says.
One of the technologies his team uses is automatic tube-current modulation, which helps CT scans to maintain constant image quality regardless of patient attenuation characteristics, allowing the radiation dose to patients to be reduced. For example, a CT scan with this technology will reduce exposure when the tube is over a part of the body with less tissue, rather than send a consistent amount of radiation throughout the test.