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Joint Commission rolls out XR-29-esque rules today

by John W. Mitchell , Senior Correspondent
The Joint Commission rolled out new standards today designed to improve radiation-dosing safety. The standards serve as a precursor of sorts to the Medicare XR-29 rules slated to go into effect January 1. The new measures also serve as a reminder that CMS, the American College of Radiology and the Medical Imaging and Technology Alliance (MITA), are all on board with exacting dosing standards.

“There have been instances where equipment has been used improperly and patients have received accidental higher doses of radiation than recommended,” Thad Flood, industry director for MITA, told DOTmed News.

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Unlike XR-29 — which includes quality control features and impact reimbursement in order to promote dose reduction and patient safety — the Joint Commission standards will affect hospital and clinical accreditation.

“Over the past two years, The Joint Commission conducted research and literature reviews and monitored media reports regarding several significant patient safety incidents related to radiation therapy and the provision of diagnostic imaging services,” Joyce Webb, project director, Division of Healthcare Quality Evaluation at the Joint Commission, told DOTmed News.

“Based on this research, The Joint Commission now requires organizations to document, in a retrievable format, the radiation dose index on every study produced during a diagnostic CT exam," continued Webb. "Joint Commission accredited organizations may choose to either implement automated processes such as those addressed by XR-29 or other computerized or manual processes to capture this data and demonstrate compliance with this new requirement.”

The new wide sweeping Joint Commission standards in effect today are primarily related to documentation of the dose, establishing baselines for imaging protocols, requirements to review outliers and comparison to external benchmarks, and establishing and maintaining protocols.

“Hospital and clinic administrators have a lot of things to worry about on any given day,” Flood said about the XR-29 rules. “There may be free software upgrades available to help them meet the standards, but on high volume, older machines there is often a good enough financial incentive related to the reimbursement cuts that make it worth replacing.”

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