With a 2027 compliance deadline, healthcare leaders must take a proactive stance on dose monitoring, patient safety and workforce education.
The Centers for Medicare and Medicaid Services (CMS) have implemented a new rule: hospitals and imaging centers are now required to track and report radiation exposure from computed tomography (CT) scans. CMS is also requesting that providers evaluate whether each scan is appropriate and necessary.
This new regulation, which requires compliance by 2027 to avoid financial penalties, seeks to improve consistency in CT radiation doses and create safer diagnostic imaging practices nationwide.
Year after year, researchers have raised concerns about the long-term risks of continuous radiation exposure. A one-time CT scan presents minimal danger, but the U.S. performs more than 93 million CT scans annually, many on patients over the age of 60, fueling the conversation about cancer risks. These scans are estimated to have resulted in approximately 103,000 future cancers.
CMS’s new requirement mirrors a long-held policy by healthcare accreditation agency The Joint Commission. As such, the requirement should not be entirely unexpected, and it will likely boost enforcement of current radiation safety protocols across hospitals and health systems.
The update has drawn mixed opinions. Organizations like The Leapfrog Group have praised the policy’s focus on patient safety. On the other hand, the American College of Radiology initially opposed the rule, claiming it would increase costs and is overly complicated.
How Does This Affect Hospitals and Imaging Centers?
Institutions with in-house radiation safety specialists, committees and ALARA-focused policies and strategies are likely to adopt the change with minimal disruptions. Smaller, rural clinics with fewer resources could find CMS’s rules more difficult to implement.
In these instances, providers can benefit from relying on updated technologies with radiation dose reduction built into their very design. Modern CT systems from manufacturers like Siemens Healthineers have automated features integrated to regulate dose in real time. These include:
- SAFIRE (Sinogram Affirmed Iterative Reconstruction) – A unique CT iterative reconstruction algorithm that uniquely allows for up to 60% lower radiation dose in your CT examinations without compromising image quality.
- ADMIRE (Advanced Modeled Iterative Reconstruction) - Raw-data statistical modeling is a new approach to minimizing artifacts. Rather than focusing on one detector element for defining the data, ADMIRE also evaluates data from surrounding elements. In addition, noise cancellation in the image space keeps noise lower than ever. Large-scale analysis in all directions separates anatomical structures from the noise, and results in excellent image quality.
- CARE Dose 4D - CARE Dose 4D is Siemens Healthineers’s technology for automated exposure control. It optimizes dose and helps deliver the desired diagnostic image quality across a broad spectrum of patient sizes, ages, exam types and clinical indications.
Best Practices for Updated Protocols
Successful compliance can be backed up by organized and ongoing evaluations. When approaching radiation safety in my previous role as a hospital administrator, we chose to build a program that evaluated the two most common CT exams (CT Head w/o and CT Abd/Pelvis w/only) and compared them to the national baseline. If the average radiation dose exceeded the baseline, we investigated immediately. Our goal was to ensure that, no matter the technologist scanning the patient, the dose level should remain relatively consistent.
I anticipate seeing CMS require hospitals to set similar guardrails around permissible scan modifications. Pre-scans, for example, could be providing an unnecessary dose, so by setting clear expectations, you can make protocols more regimented at a higher level. These sorts of guardrails can capture the most utilized scans, and a regular dose review should further be incorporated into your own Radiation Safety Committee meetings.
A Data-Driven Safety Culture
Adopting a data-driven approach will help benchmark performance and demonstrate compliance. Dose monitoring platforms allow analysis and reporting to CMS while helping providers reduce scan range, shorten scan time and eliminate unnecessary pre-scans, with the goal of conducting a diagnostic scan with the lowest possible amount of radiation.
Integrating Training and Workforce Development
Even the most advanced software cannot substitute for in-depth knowledge among technologists. There’s a gap between senior, tenured technologists and those in the workforce who are just embarking on their careers. To ensure these technologists gain the requisite experience in dose reduction, your organization can turn to a variety of training programs that put safety at the forefront. Image Gently (for pediatric imaging) and Image Wisely (for adult imaging), for example, can help organizations improve radiation safety measures and competency. These programs offer formal radiation safety training and certification to reinforce best practices and encourage continuing education.
What Hospital Leaders Can Do Now:
- Partner with vendors offering AI-supported dose regulation
- Train technologists in certified radiation safety programs
- Ensure imaging departments align with CMS’s 2027 reporting deadline
- Embed dose-review metrics into monthly safety meetings
Communicating radiation safety initiatives to patients is just as important. Facilities can provide informational brochures, posters in waiting or imaging rooms and digital resources about radiation safety. These efforts build trust and promote transparency with patients who will also benefit from high-quality care.
CMS’s new rule is a meaningful step toward further understanding the correlation between radiation exposure and cancer risk to provide better patient care. As the 2027 deadline approaches, healthcare providers must act swiftly to assess their imaging infrastructure to ensure readiness for current and future changes.
Cassling’s Commitment
Cassling is positioned to help its healthcare partners navigate these changes and adopt them with a seamless transition. We connect hospitals and health systems to a variety of services and solutions built with radiation safety in mind, including the latest CT systems equipped with dose reduction applications and other technology that can limit dose and help keep your patients and providers safe.
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