The creation of a regional VPN (virtual private network) allowed a hospital in Seattle to use image sharing technology to reduce the need for repeat imaging of trauma patients transferred from one institution to another.
According to an article published online June 13 in the Journal of the American College of Radiology, about half of all trauma patients undergo at least one CT scan at a referring institution before they transfer, and about 20 percent have a CT scan that is repeated.
A 2012 study published in the Journal of Trauma and Acute Care Surgery looked at 211 transferred trauma patients who had received a CT scan at the transferring institution, determining that 82 of the patients had at least one repeated scan. The repeated scans led to additional hospital charges--an average of $1,762--and additional exposure to radiation.
Harborview Medical Center in Seattle implemented the VPN in 2005 in an attempt to cut down on repeated scans and to eliminate the need to share studies by recording and distributing them on CDs. According to the lead author Kevin J. Psoter of the University of Washington, Seattle, and his colleagues, more than 120 facilities are connected to Harborview through the VPN, while others can use a cloud-based image sharing system.
The researchers looked at more than 81,000 trauma patients admitted to Harborview between 1996 and 2010, 44 percent of whom were transfer patients. They determined that head CT utilization increased slightly between 1995 and 2005, when the VPN was implemented. There was no significant difference between transfer and direct-admit patients.
While utilization remained relatively unchanged between 2005 and 2010, "significantly higher utilization rates were observed for direct-admit patients," the authors said. They found similar patterns when they analyzed pelvic, abdominal and thoracic CT utilization.
The authors concluded that since the VPN was implemented in 2005 the "utilization rates of CT of different body regions have been higher for direct-admit trauma patients compared with transfer patients."