BAPETEN challenge for the development of the Indonesian diagnostic reference level (I-DRL)

Abstract

Optimization of radiation protection and safety in medical exposures for diagnostic and interventional radiology (DIR) examinations is based on the effort to provide minimal doses by taking into account the sufficient image quality to diagnose the patient’s disease. To facilitate the evaluation of the effectiveness of the optimization implementation in medical exposure, especially for diagnostic purposes, an indicator called the Diagnostic Reference Level (DRL) is used. BAPETEN has provided a web-based database application called Si-INTAN (National Patient Dose Information System) for online input of patient dose data on CT Scan, Fluoroscopy, Diagnostic Nuclear Medicine, General Radiography, Dental Radiography, Mammography modalities. This application functions as a comprehensive tool for establishing and providing Indonesian DRL (I-DRL) values so that it can be referred to by all DIR facilities in Indonesia. To improve the capability of this application in its role as a tool for determining the value of national DRL, the authors identify the challenges and propose action plans as a solution. It is concluded that it is necessary to stipulate regulations on reporting patient dose data, support of international and professional organizations, and hospital management support in mitigating patient dose data. Coordination is performed with the Indonesian Ministry of Health regarding the integration of the Si-INTAN system with the QUADRIL (Quality Assurance Audit for Diagnostic Radiology Improvement and Learning) application system and hospital accreditation systems.