Sharing imaging exams from one institution to another via picture archiving and communication systems (PACS) can greatly reduce the need to repeat the procedure.
That's the conclusion of a recent study of 267 patients conducted at the University of California San Francisco and published in the March issue of American Journal of Roentgenology.
Many of the patients referred to the facility had undergone imaging elsewhere. "Review of these images, which are most commonly on a CD, is critical to clinical decision making," the researchers noted. Repeat imaging is performed when the prior image is hard to read or not available.
The researchers found that importing outside CT or MRI images to the PACS reduced the rate of repeating imaging significantly more than a review of outside images on a CD, which was time-consuming, less readily available, and "unwieldy." The PACS allowed for faster review and side-by-side comparison of studies; they were also available enterprise-wide. When outside images were imported to the PACS only 11% of them needed to be repeated, about the same number (13%) of images performed only at the facility, sparing the patients unnecessary costs and radiation.
In contrast, when outside images were not at all available, patients were more than six times likely (72%) to undergo repeat imaging. When outside images were available but not imported to a PACS, the patients were almost five times as likely (52%) to undergo repeat imaging.
The researchers pointed out that although importing imaging between facilities reduced overutilization, the current industry payment system did not support the activity; while repeat imaging was reimbursable, the cost for importing the images is not.
"We expect that the results of this study and others showing the clinical benefits of image sharing will make the case for appropriate incentives for use of this service," the authors said.
The government and providers have previously recognized that health IT is an effective tool to reduce duplicative and unnecessary tests, which decreases the cost of care and benefit patients.
The increase in PACS by hospitals will contribute significantly to that trend, with the global market predicted to almost double by 2017.
To learn more:
- read the study abstract
- see how EHRs can reduce unnecessary care