A Collaborative Approach to Dose Management: Sectra DoseTrack at UHCMC

In June 2013, University Hospitals Case Medical Center (UHCMC) in Cleveland, Ohio, began feeding information from six of its 24 CT systems into a new dose-monitoring and reporting platform called Sectra DoseTrack™. Dave Jordan, senior medical physicist for the organization, explains that UHCMC turned on the system in early September, after feeding data to it for almost three months. “We were fortunate in that we were able to implement a system like this without a problem we needed to solve,” Jordan notes. “It wasn’t a response to a specific issue with radiation dose that we needed to solve—or a mandate we needed to meet.” Instead, Jordan says, he and his colleagues became interested in using the platform as a way to address dose monitoring and management more proactively, as well as to make deeper collaboration possible among medical physicists, radiologists, and technologists. “The American Association of Physicists in Medicine recently released some great practice guidelines¹ for getting more involved in looking at the clinical protocols in CT,” he says. “I think we have a lot to learn from working with this system.” Evaluation and Strategy Jordan first began evaluating dose-monitoring platforms while working as an independent consultant. “I became aware of these systems three years ago, and from a general perspective, I’ve been interested in what they would really do for an organization,” he says. “After all, once you start collecting the data and creating reports, you’re going to commit to looking at them—and after you’ve committed to that, you’re going to have to start doing something about what you’re seeing. You have to be careful about that. You can’t just implement a system because it’s a cool toy; it needs to support your business objectives.” After Jordan joined UHCMC two years ago, his perspective broadened to accommodate the specific needs of the organization. “Our driver, in looking at these systems, was that we were seeking something with a lot of flexibility to slice and dice all this information we haven’t been able to see before,” he says. “We want to figure out if we need to improve, or if we can have confidence in the way we’re doing things right now.” The system from Sectra appealed to Jordan because of that very flexibility. “The interface on this system gives you a lot of options,” he says. “It doesn’t force you to look at certain default datasets or graphs. You pick the subset of patients, procedures, dates, or any other combination of parameters, and you get whatever it is you were looking for immediately.” That flexibility is valuable to the team at UHCMC precisely because it is attempting to take a proactive approach to dose management, rather than troubleshooting a particular issue. Jordan explains, “We wanted the capability to uncover things we didn’t know that we didn’t know.” Data Aggregation and Implementation In June, UHCMC began feeding data from six of its CT systems into Sectra DoseTrack; upon turning the software on in September, Jordan was immediately able to see dose data for three months (and 6,300 studies). “Compared with what I usually deal with, this is the big-data level,” he says. It’s just a drop in the bucket, however: With 24 CT systems and four PET/CT systems spread across its 10 hospital campuses, the University Hospitals system has far more data to aggregate and analyze in the future. “First, we’re going to feed in the rest of our CT scanners; then, we’d like to put in information from our interventional systems,” Jordan says. Within a few days of implementing the system, Jordan and his team were already seeing results. “From the very beginning, with just a few months’ worth of data, we could go in and look at the performance of individual scanners,” he says. “When we saw things that looked strange, we were able to drill down and look into what had happened.” In the end, all the CT systems turned out to be performing well. Jordan says, “The system draws attention to what needs a closer look.” In the future, Sectra DoseTrack will enable UHCMC to monitor and manage dose across large patient populations, its multitude of CT systems, and its many facilities—a boon to its team of medical physicists. “When you need to understand what’s going on with radiation dose with real patients, Sectra DoseTrack puts it right in front of you,” Jordan says. “If what you’re looking for isn’t right on the home screen, you can get there in two clicks. It’s a far cry from having to pull numbers from individual scanners and build a spreadsheet.” He continues, “When you decide, on Tuesday morning, that you want to see how the pediatric CT scanner is doing, in two clicks, you can have all the data from the past month. It’s a huge time savings.” Jordan and his colleagues also will be able to save time calibrating CT protocols—a growing priority for the organization’s medical physicists, as they become more collaborative with radiologists and technologists. “You’d never be able to look at every detail of every protocol on every scanner: There are way too many variations,” he says. “With Sectra’s system, we can see what we need without going to every individual scanner and scrolling through its details.” Jordan looks forward to the more cooperative approach to dose management that the system will make possible. “We’ll be able to pull out different datasets to initiate conversations with technologist supervisors and radiologists about what all of this means to them—and what kinds of questions it raises,” he says. “Sectra DoseTrack will be a great guide for those discussions.” Cat Vasko is editor of ImagingBiz.com and associate editor of Radiology Business Journal.