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Expert panel co-chaired by Dr. Tim Dowdell recommends modernizing Ontario’s radiation protection legislation

Toronto, July 22, 2016

By Kaitlyn Patterson

Dr. Tim Dowdell
Dr. Tim Dowdell

An expert panel co-chaired by Dr. Tim Dowdell, the radiologist-in-chief at St. Michael’s Hospital and medical director of the hospital’s Centre of Excellence in Medical Imaging, has made recommendations on how to modernize Ontario’s radiation protection legislation.

Health Quality Ontario formed the Expert Panel to Enhance the Safety and Quality of Energy-Applying Medical Devices in 2015 to review the Healing Arts Radiation Protection, or HARP, Act.

Despite rapidly changing technology, the HARP Act has remained unchanged since it was passed more than 30 years ago to ensure the safety of patients receiving X-rays.

Dr. Bruce Gray, a radiologist and co-director of the Centre of Excellence in Medical Imaging at St. Michael’s, and Dawn-Marie King, the director of Medical Imaging and Laboratory Medicine at St. Michael’s, were also members of the expert panel.

The panel’s recommendations to the Ministry of Health and Long-Term Care extend beyond the HARP Act to accommodate all modern energy-applying medical devices, or EAMDs, such as MRIs, CT scanners, nuclear radiation devices and therapeutic and image-guided procedures.

The six recommendations are:

  • to expand the scope of legislation for radiation protection in Ontario
  • establish a new governance structure for quality oversight of EAMDs
  • use a phased approach to introduce modernized legislation and regulation
  • strike task forces on an ongoing basis to develop or update regulatory requirements where indicated by the Committee to Regulate Devices
  • continue to develop the digitally-enabled infrastructure required to drive system learning
  • develop and foster mechanisms to enhance public reporting and transparency in the system.

“Since the HARP Act was introduced many years ago, changes to the health care landscape and broad advances in technology have driven the development of many new EAMDs,” said Dr. Dowdell. “The HARP Act does not consider or address these new devices, so it is unable to accommodate and regulate health technologies as they evolve.”

The panel advised that modern legislation preserve the current function of existing legislation to protect from ionizing radiation, address existing shortfalls – such as new roles and scopes of practice among providers – and accommodate anticipated and unanticipated innovations.

To maintain the person-centred focus, the panel also developed the concept of the quality contract. This outlines the implied obligation the health care system has to ensure that benefits outweigh the risks for patients exposed to EAMDs for diagnosis or therapy.

“Generally in these highly technical areas, patients do not have the knowledge or expertise required to properly evaluate the risks and benefits of a procedure or technology,” said Dr. Dowdell. “The quality contract makes the health care system accountable for mitigating the risks and optimizing the benefits for patients, so they can avoid radiation risks from EAMDs later in life.”

The panel recommended that a phased approach be employed to implement a modernized radiation protection legislation. This approach would allow urgent system priorities to be immediately addressed, while the final framework was developed. It would also show what methods worked best during the process to produce a comprehensive and tested legislative framework.

“The panel’s recommendations will help with the development of an adaptive legislative framework that leverages information technology and is able to accommodate new health technologies in a rapidly changing health-care environment,” said Dr. Dowdell.

View the full report.

About St. Michael's Hospital

St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in 27 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael's Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.