The use of an electronic medical record (EMR) for reviewing portal images dramatically improves compliance with timeliness and record keeping, according to a study in the July issue of the Journal of the American College of Radiology. Portal images are used to verify the positioning of patients during daily radiation treatments to improve the accuracy of the radiation field placement, to reduce exposure to normal tissue and to deliver accurate dose to tumor volumes.

"The benefits of the implementation and utilization of an EMR have been well documented. Other studies have shown that the use of EMR's improves the quality of care, saves time and decreases cost," said Andre Konski, MD, MBA, MA, co-author of the article. Konski is chief of radiation therapy at the Barbara Ann Karmanos Cancer Center; and professor and chair of the Department of Radiation Oncology at theWayne State University School of Medicine in Detroit.

The use of an EMR to review portal images was initiated at the investigators' institution in March 2010. Before this, portal images were reviewed on either radiographic film or printouts from machines equipped with electronic portal imaging. Patients who were treated by attending physicians present before and after the switch to the EMR were randomly selected for review of their portal images from 2009 for radiographic film and March to June 2010 for portal images in the EMR. The images were reviewed for their compliance with proper verification per departmental policy.

A total of 411 portal images were reviewed. Results showed that there was a statistically significant improvement in compliance with portal image review policy with the advent of using the EMR to review portal images.

"The use of an EMR for reviewing portal images dramatically improves compliance with timeliness and record keeping. More timely review of portal images is critical because it allows for higher quality care in the treatment of patients with radiation," said Konski.

"Given this study's findings, in accordance with a nationwide push for transitioning the EMR's, reviewing portal images via an EMR should be standard of care," he said.