On the feasibility of Epic electronic medical record system for tracking patient radiation doses following interventional fluoroscopy procedures

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The purpose of this work was to investigate the feasibility of utilizing an electronic medical record system, Epic (Epic Systems Corporation, Madison, WI), for tracking patient radiation doses following interventional fluoroscopy procedures. Following an interventional procedure, before an examination is marked as completed, the new technologist workflow necessitated inputting cumulative air kerma and dose/kerma area product reported by the interventional system in Epic. Data reported by the technologists is stored in Epic’s production database, then converted and stored in Epic’s analytical database, and accessed via a customized SQL query. Selectrus was used as a report delivery tool for internal extracts. Patient-specific radiation dose audits are performed using Epic’s front facing graphical user interface called Hyperspace. Using this platform periodic monitoring and auditing of radiation dose data has been successfully implemented at our institution over a year. All cases where radiation dose estimates have exceeded recommended thresholds have been audited and followed up with the respective physicians. Limitations of this approach include manual data entry by the technologists following the procedure which may be subject to human error. Most common error (< 1% of reviewed cases) is switching of cumulative air kerma and kerma/dose area product values; this error is easily identifiable given kerma/dose area product is greater than cumulative air kerma. Tracking patient radiation doses following interventional fluoroscopy procedures using Epic electronic medical record system is feasible. This type of setup is configurable at other healthcare institutions that utilize Epic system as their electronic medical record system.