Complete guide to Australian hospital radiology — imaging services (CT, MRI, X-ray, ultrasound), PACS (Picture Archiving and Communication System), RIS, RANZCR standards, Medicare radiology billing, radiation safety, and radiology software.
RANZCR sets Australian radiology standards. PACS enables instant image access and sharing. MBS covers outpatient radiology. This guide covers Australian hospital radiology management.
Imaging Modalities
| Modality | Description | MBS Item? | Radiation |
|---|---|---|---|
| X-ray | Plain radiography | Yes | Low |
| CT | Computed tomography | Yes | Moderate |
| MRI | Magnetic resonance imaging | Yes (some) | None |
| Ultrasound | Sound wave imaging | Yes | None |
| Fluoroscopy | Real-time X-ray | Yes | Moderate |
| Nuclear medicine | Radioactive tracer imaging | Yes | Moderate |
| Mammography | Breast imaging | Yes (BreastScreen) | Low |
| DEXA | Bone density | Yes | Very low |
Radiology Workflow
- Request: Doctor requests imaging with clinical indication
- Scheduling: Schedule examination (urgent vs routine)
- Patient preparation: Prepare patient (contrast, fasting, etc.)
- Image acquisition: Radiographer acquires images
- Image review: Radiologist reviews and interprets images
- Report: Radiologist generates report
- Report distribution: Report sent to requesting doctor via RIS/EHR
- Image storage: Images stored in PACS
- Billing: MBS claim or hospital billing
Radiation Safety in Australia
- ARPANSA: Australian Radiation Protection and Nuclear Safety Agency sets radiation standards
- Radiation dose monitoring: Track cumulative radiation dose for patients
- ALARA principle: As Low As Reasonably Achievable — minimise radiation
- Pregnancy screening: Screen all women of childbearing age for pregnancy
- Lead shielding: Appropriate shielding for patients and staff
- Staff monitoring: Radiation dose monitoring for staff (dosimeters)
- Equipment quality: Regular equipment QA and calibration
Frequently Asked Questions
- What is RANZCR?
- RANZCR (Royal Australian and New Zealand College of Radiologists) is the professional body for radiologists in Australia and New Zealand. RANZCR: 1) Sets radiology training and practice standards, 2. Publishes imaging guidelines (Imaging Guidelines), 3. Accredits radiology training programmes, 4. Provides quality assurance programmes, 5. Sets radiation safety standards, 6. Manages the RANZCR Quality Use of Diagnostic Imaging programme.
- What is PACS and how does it work in Australian hospitals?
- PACS (Picture Archiving and Communication System) is a medical imaging technology that stores, retrieves, distributes, and displays images. Australian hospitals use PACS for: 1) Storing all imaging (CT, MRI, X-ray, ultrasound), 2. Viewing images on workstations, 3. Sharing images between departments and hospitals, 4. Integration with EHR, 5. My Health Record image sharing. PACS replaced physical film and enables instant image access.
- How is radiology billed in Australian hospitals?
- Australian radiology billing: 1) Inpatients — hospital funds radiology (public) or private health insurance (private), 2. Outpatients — MBS (Medicare) covers radiology with MBS item numbers, 3. Private radiology practices — MBS + gap payment. MBS radiology items cover: CT, MRI, X-ray, ultrasound, fluoroscopy, nuclear medicine. Some items require specialist referral.