In the current global healthcare environment, providers are increasingly obliged to balance tight financial budgets whilst ensuring that patient care is not jeopardised. There are large regional and country-specific differences in what determines the decision-making process when purchasing interventional X-ray equipment. A combination of healthcare budget restrictions, political instability and economic crises has heightened consideration of the price of interventional X-ray systems. Regulatory pressures and guidelines on dose requirements fuel the demand for interventional X-ray equipment with higher image quality and lower dose features, in addition to dose monitoring features.
Dose management guidelines are progressively playing a part in the increased demand for dose management software and hardware solutions, which not only track dose for individual patients for specific procedures, but also monitor the administration of dose by clinical staff. Most hospitals in emerging countries are still waiting for local regulations on dose management to be issued, before updating their interventional X-ray systems. North America is the biggest market for dose management and dose optimisation features, with Australia and Japan predicted to be upcoming markets. Singapore and Taiwan have a tendency to follow American and European trends; an increased focus on dose management is predicted in these markets from 2016 to 2021.
Research into impact of radiation
There is also increasing research being conducted on the impact of radiation exposure, with some studies proving risk of cataract to US radiologic technologists after exposure to low doses of ionizing radiation. Regulatory requirements for medical radiation are emerging in the United States, but implementing dose management practices and gaining visibility of dose data are still relatively new to clinicians. Thus, healthcare providers are searching for the opportunity to test dose management without compromising image quality.
Dose management regulations
In February 2018, the European Directive will be implemented in all European countries, making it a legal requirement for interventional X-ray procedures and equipment to meet the new high standards of radiation safety. Additionally, the new Centres for Medicare & Medicaid Services (CMS) payment program in the United States, MACRA, includes dose management-related requirements clinicians must follow for more accurate and complete reimbursement.
Developments in dose monitoring
New systems now commonly include smarter dose tracking based on the examination being performed, patient attributes, and automatic scan program adjustment. Many of these features are also part of wider dose-monitoring platforms for integrated use across different modalities, enabling seamless tracking of patient dose between departments. Dose calculation is increasing in accuracy, and is now being tailored to unique patient demographics as well as the interventional procedure.
Greater awareness of radiation dose continues to increase the focus on clinician safety, with many dose-monitoring platforms focusing on the physicians and clinical staff that carry out procedures. In addition, vendors are increasingly offering clinical staff training to help raise awareness and drive best practice. While there are still substantial developments to be made in universal benchmarking of dose for the rising uses of interventional X-ray procedures, recent advances controlling the doses of interventional X-ray systems are forecast to be a key driver of interventional system upgrade in the next five years.
Dose optimisation, dose reduction, and dose management features are at the foreground of developments in technology and software, with marketing of interventional X-ray systems endorsing high image quality for lower dose administration in developed countries. However, interventional X-ray manufacturers must account for the price-driven developing markets, in particular those with economic and political instability, as part of their marketing strategy. With the growing incidence of interventional procedures comes increased attention of the adverse effects of exposure to radiation. With increased regulatory pressure on dose measurement for both patients and clinical staff, advanced interventional X-ray technology and software is required to monitor dose more accurately and optimize the balance between radiation dose and system performance for common procedures.
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