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DoseID – Affordable Joint Commission Compliant CT Dose Monitoring Solution

Are you looking for a CT Dose Monitoring solution or frustrated by the complexity of your current solution? Is your current solution confusing to the point of non-use? If so, please consider DoseID.

DoseID is an affordable, turn-key CT Dose Monitoring service for hospitals, health systems, imaging centers, and physician practices. Our DoseID service leverages your participation in the ACR’s Dose Index Registry to comply with TJC’s mandate to create Expected Dose Ranges for every study the identifies individual exams that exceed their expected range, and it does so with little daily impact on staff and without having to purchase more expensive third-party solutions.

  • Is your department struggling to understand or meet the Joint Commission’s requirement PI.02.01.01 requiring facilities to establish expected dose ranges for every CT exam, identify studies that exceeded the upper threshold, and then review and analyze CT dose incidents – incidents when the actual total dose exceeded your facility’s dose threshold for that exam? 
  • Did your facility purchase an expensive third-party platform only to discover it is too complex and difficult to use, often to the point it goes unused? 
  • If your facility purchased a third-party platform did it have to hire dedicated staff just to use it, or are you struggling to keep staff trained to use it?
  • Is your department still trying to meet this requirement on your own, but finding it difficult and time consuming? 
  • Is department management and/or staff frustrated with your current solution? 
  • Is your facility spending more than $4,000 per year?
  • Would you like a less expensive solution that actually provides you with actionable information your staff can use?

If you answered “yes” to any of the above questions take a look at our DoseID program.  We provide a yearly service at a cost less than many facilities spend in 1 to 3 months on other solutions, and we do most of the work for you.  No hardware or software to purchase; no upfront costs; and, no  long-term commitments. 

Our DoseID program is one of the most cost-effective and user-friendly CT dose optimization programs available designed to meet the Joint Commission’s dose incident identification requirements. 

We are able to do this because we leverage your participation in the ACR’s Dose Index Registry.   The DIR is a powerful tool, yet many facilities fail to grasp its utility or take advantage of it.  We help you leverage your participation in it to optimize your doses and meet TJC’s requirements, and do so at a fraction of the cost of other programs.   

Don’t misunderstand – the expensive third-party platforms are wonderful products, particularly for health systems with large budgets and the staff to use them.  I would never discourage anyone from purchasing them if they have the resources to purchase and use them. However, that is not the world many small to mid-sized community hospitals find themselves in today.  DoseID is designed to meet the needs of facilities that want an effective program, but one which is also affordable and easy to implement and understand.   

Our service requires no up-front costs, no hardware or software to buy, and there are no annual maintenance or support fees to pay. Because this is a service, we do the work for you and work directly with staff to identify dose reduction opportunities. Simple, but very effective. Click here to see what our customers are saying.

For more information visit or email us by clicking here

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Important Announcements Concerning the Dose Index Registry – Please Read If You Use the DIR

The NRDR has announced 3 important changes to the DIR

  1. The DIR is dropping support of Secondary Capture images as a means for cataloging doses and will accept only Radiation Dose Structured Reports (RDSRs) at some point in the near future;
  2. The DIR is retiring the following 3 Operational Reports and will, instead, make this information available in a recently added set of Interactive Reports due for release in July, 2019; and,
  3.  The DIR is hosting a webinar to  review the new Interactive Reports on June 27, 2019.

I have included the NRDR’s email announcing each change at the end of this email.   

Secondary Capture Discussion:

The first email copied below was sent to a facility which is currently using a CT platform which is not sending RDSRs to report doses, but is sending Secondary Capture images instead.  As you will see, the email asks that facilities switch to RDSRs by September 3, 2019.  It adds that scanners which send Secondary Capture Images in addition to RDSRs may continue to send secondary capture images, they just won’t be used. 

If your scanner is natively XR-29 compliant you should (or are able to be) sending RDSRs.  If your scanner is not XR-29 compliant and/or you purchased a third-party solution to achieve XR-29 compliance, you should speak your system’s service engineers and/or your third-party solution support desk as to whether or not you can send RDSRs. 

As the NRDR wrote in its email below, if you have barriers to sending RDSRs (MB: Or if you just have questions) they are happy to work with you.  Simply contact the National Radiology Data Registry support team at for assistance.  I’ve had many occasions to work with the Help Desk and have always found them very professional and helpful. 

Retiring of 3 Operational Reports and the Addition of several Interactive Reports

The second email copied below is the NRDR’s announcement of several reporting changes, specifically the retiring of the following Operational Reports:

  1. Dose Information by Exam;
  2. CTDIvol Over Time; and,
  3. Summary of Data Submitted.

These will be replaced by the following Interactive Reports

  1. CT Standardized Dose Index Reports: Exam Search
  2. CTDIvol Standardized Dose Index Reports: Scatterplot Over Time; and,
  3. CT Summary of Data Submitted.

I’ve used all three Operational Reports as well as their new Interactive Report counterparts and have found the new Interactive Reports superior to their older counterparts.  While change generally requires a learning curve, this learning curve is fairly short and intuitive.  One of the main benefits of the new reports is that they provide much more flexibility to design the report and obtain either overall or the limited data sets you are interested in reviewing on demand – by facility, by scanner, by RPID, by Exam Name, by data, etc.  Give it a try and spend an hour or so testing it out – I think you’ll like it. 

Interactive Report Webinar 

The third email below is the announcement of a webinar to review the new Interactive Report features.  The webinar, titled New DIR CT Interactive Reports Webinar, is scheduled for Jun 27, 2019 1:30 PM EDT.  Click here to register.

————————- NRDR Emails ————————-

Ending of Support for DIR Secondary Capture Email

Dear DIR Participant,

Thank you for your ongoing participation in the American College of Radiology’s (ACR) Dose Index Registry (DIR).  Your participation in the registry not only affects quality improvement at your own facility, but also establishes benchmarks that other facilities use for performance comparison and ultimately to reduce unnecessary patient radiation exposure across all participant sites. 

When we launched the DIR in 2011 few CT scanners were capable of generating Radiation Dose Structured Reports (RDSRs).  Therefore, we accepted exams directly from a RDSR as well as from secondary capture images (without RDSR).  In the years since the registry launch, and with the implementation of the XR-29 standard on CT scanners, most scanners submitting DIR data are now capable of producing RDSRs.  In addition, the secondary capture method has proven to be less effective than RDSR in terms of data quality, information processing time, and resource support requirements.  In response to the industry technology changes, and to the overall limitations of secondary capture, we would like to transition DIR support to RDSR submission only.  Consequently, we are requesting that all sites shift submission of all of their registry data to the RDSR format as soon as possible. 

Your site is one of several identified as sending secondary capture images without RDSRs in the past three months.  As such, we ask that you switch over to RDSR transmission by September 3, 2019.  Though we would prefer to receive the RDSR message exclusively, we can accept an accompanying secondary capture (it will not be processed) in the event your system mandates sending both. 

The continued success of the Dose Index Registry and the resulting improvement in radiological quality is dependent on active participation by sites such as yours.  We realize that making this change may result in modifications to your processes/systems with potential effort required by you.  ACR thanks you in advance for your willingness to consider this change.  If you have barriers to sending the RDSR we will be more than happy to work with you in an attempt to overcome these issues.  Please contact the National Radiology Data Registry support team at for assistance.


Retiring of 3 Operational Reports and Addition of new Interactive Reports Email

Dear DIR User,

 In the beginning of July we will be retiring the following DIR Operational Reports: Dose Information by Exam, CTDIvol Over Time, and Summary of Data Submitted.  The same content in the Operational Report can be found in a corresponding Interactive Report. 

 Operational Report Interactive Report
Dose Information by Exam CT Standardized Dose Index Reports: Exam Search
CTDlvol Over Time CT Standardized Dose Index Reports: Scatterplot Over Time
Summary of Data Submitted CT Summary of Data Submitted

We have implemented Interactive Reports which allows users to query, filter, and navigate through data to identify patterns and gain insights on their data.  During the next few weeks, we encourage you to familiarize yourself with the Interactive Reports.  Included at the end of the email are links to articles outlining the use and content of these Interactive Reports.  We are also available at to answer any questions you may have about the reports.

DIR Interactive Reports

CT Standardized Dose Index Reports: Exam Search

CT Standardized Dose Index Reports: Scatterplot Over Time


Webinar to Discuss New Interactive Reports Email

Dear DIR Participants,

 Please register for New DIR CT Interactive Reports Webinar on Jun 27, 2019 1:30 PM EDT at:  

Our upcoming webinar will focus on the next set of Interactive Reports for the Dose Index Registry due for release in July, 2019. These reports will allow users to quickly identify which exam Short Names are outliers (compared to the entire registry) and drill-down to see both individual exams and long-term data trends. We’ll also cover new reports for downloading data in a format similar to the existing quarterly Excel reports.

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Joint Commission Annual Fluoro Training Requirements May Be Rescinded Soon

Thought you might find this interesting.  This was sent to me earlier today.  Looks like TJC will soon announce they are rescinding the annual fluoroscopy education requirements. Stay tuned!

Michael Bohl
Dose Registry Support Services


Sent: Thursday, June 13, 2019 12:48 PM
To: Michael Bohl

Subject: TJC fluoro training

From a recent release:

(To be published in the August 2019 Perspectives)

Effective immediately, The Joint Commission is deleting Standard HR.01.05.03, element of performance (EP) 15 from the Ambulatory Care, Critical Access Hospital, Hospital, and Office-Based Surgery programs.

For reference, the text of the deleted EP is as follows:

Standard HR.01.05.03, EP 15: The  verifies and documents that individuals (including physicians, non-physicians, and ancillary personnel) who use fluoroscopic equipment participate in ongoing education that includes annual training on the following: 
 – Radiation dose optimization techniques and tools for pediatric and adult patients addressed in the Image Gently® and Image Wisely® campaigns 
 – Safe procedures for operation of the types of fluoroscopy equipment they will use 
 Note 1: Information on the Image Gently and Image Wisely initiatives can be found online at http://www.imagegently.organd
 Note 2: This element of performance does not apply to fluoroscopy equipment used for therapeutic radiation treatment planning or delivery.

Since the launch of HR.01.05.03, EP 15 on January 1, 2019, The Joint Commission has determined through stakeholder and customer feedback that this requirement is redundant to other accreditation requirements and would be burdensome to conform with annually. Therefore, an annual training requirement will not be required, and an  assessment of staff and physician competency to provide fluoroscopy services will continue to be assessed during the on-site survey using accreditation standards that currently exist in the “Human Resources” and “Medical Staff” chapters.

This deletion will be posted on The Joint Commission website at It will no longer be part of the Comprehensive Accreditation Manuals for the above programs as of the January 2020 E-dition® update and January 2020 hard copy publications.