Patient radiation exposure and dose tracking: a perspective.

Much of the emphasis on radiation protection about 2 decades ago accrued from the need for protection of radiation workers and collective doses to populations from medical exposures. With the realization that individual patient doses were rising and becoming an issue, the author had propagated the concept of a smart card for radiation exposure history of individual patients. During the last 7 years, much has happened wherein radiation exposure and the dose history of individual patients has become a reality in many countries. In addition to dealing with overarching questions, such as "Why track, what to track, and how to track?," this review elaborates on a number of points such as attitudes toward tracking, review of practices in large parts of the world, description of various elements for exposure and dose tracking, how to use the information available from tracking, achievements and stumbling blocks in implementation to date, templates for implementation of tracking at different levels of health care, the role of picture archiving and communication systems and eHealth, the role of tracking in justification and optimization of protection, comments on cumulative dose, how referrers can use this information, current provisions in international standards, and future actions.