HOUSE OF REPRESENTATIVES

H.C.R. NO.

207

TWENTY-SECOND LEGISLATURE, 2003

 

STATE OF HAWAII

 
   


HOUSE CONCURRENT

RESOLUTION

 

requesting the department of health, with the assistance of the state health planning and development agency, to conduct a study regarding medical imaging for diagnosis in Hawaii.

 

 

WHEREAS, medical imaging for diagnosis has become widespread, best exemplified by the use of X-rays, computed tomography imaging, and magnetic resonance imaging scans; and

WHEREAS, medical imaging for diagnosis has driven up the cost of health care tremendously and has also put patients at great risk of exposure to harmful radiation; and

WHEREAS, a 1999 Institute of Medicine report found that ninety-eight thousand deaths occur annually due to medical mistakes and that as many as twenty per cent of imaging studies contain a medical mistake including:

and

WHEREAS, in a study of 515 outpatient imaging facilities in one state, radiology deficiencies were reported at the following percentages in the indicated areas:

and

WHEREAS, in addition to radiology deficiencies, non-radiology deficiencies included:

and

WHEREAS, about sixty per cent to ninety per cent of non-hospital imaging studies in the United State are performed by non-radiologists, representing an increase of twenty-five per cent in non-radiologists performing radiology since 1933; and

WHEREAS, it is estimated that the country currently has a shortage of at least one thousand radiologists and that there are insufficient means to meet the demand; and

WHEREAS, there is some evidence that radiation exposure, especially in childhood, is associated with increased breast cancer risk later in life, and that the amount of risk is proportional to radiation dose; and

WHEREAS, the threats to patient safety of radiation exposure is further highlighted by the current popularity of "whole-body CT screening", which is equivalent to receiving two thousand chest X-rays; and

WHEREAS, radiation exposure also affects radiation workers whose allowable annual radiation dose has been reduced from six hundred rads in 1934 to fifteen rads in 1949, to five rads in 1957, and to the current five rads per year plus the principle of ALARA (as low as reasonably achievable), where one rad corresponds to the absorption of one hundred ergs of radiant energy per gram of body weight; and

WHEREAS, according to the Radiological Society of North America, thirty per cent to sixty-five per cent of medical imaging studies were unnecessary, with the highest over-utilization rates for computed tomography and magnetic resonance imaging; and

WHEREAS, a ten per cent reduction in unnecessary imaging would result in an annual savings of $7,500,000,000; and

WHEREAS, serious issues concerning patient and radiation worker safety, increasing and apparently unnecessary imaging costs, regulation of utilization and quality of medical imaging, as well as shortages in the profession need to be adequately addressed; now, therefore,

BE IT RESOLVED by the House of Representatives of the Twenty-second Legislature of the State of Hawaii, Regular Session of 2003, the Senate concurring, that the Department of Health, with the assistance of the State Health Planning and Development Agency, is requested, to conduct a study regarding medical imaging for diagnosis in Hawaii; and

BE IT FURTHER RESOLVED that the study is requested to examine the following:

(1) Medical imaging and patient safety, including possible increases in various types of cancer;

(2) Medical imaging and radiation worker safety;

(3) Utilization of medical imaging, including possible over-use, and the optimal balance between necessity and efficacy of medical imaging and patient and radiation worker safety;

(4) Cost of medical imaging and possible regulation;

(5) Deficiencies in radiology and non-radiology issues including performance of radiology by unlicensed or non-certified or untrained staff; and

(6) Methods to address the shortage in the profession of radiology;

and

BE IT FURTHER RESOLVED that the Director of Health is requested to submit a report of findings and recommendations, including any necessary proposed legislation, to the Legislature no later than twenty days prior to the convening of the Regular Session of 2004; and

BE IT FURTHER RESOLVED that certified copies of this Concurrent Resolution be transmitted to the Director of Health and to the Administrator of the State Health Planning and Development Agency.

 

 

 

OFFERED BY:

_____________________________

Report Title:

Medical Imaging; DOH Study