Outside Imaging in Emergency Department
TransfersJonathan Opraseuth MD
Stephen Ledbetter MD MPHAaron Sodickson MD PhD
Emergency Radiology, Brigham and Women’s Hospital, Harvard Medical SchoolBoston, MA
• Multiple clinical teams able to view imaging studies• Radiologists able to review on familiar workstations• No fear of losing CD
Decreased rate of subsequent imaging
Streamlined Patient Care
Compared Subsequent Imaging- All study types, and CT specifically- All locations, and ED specificallyRepeat and Additional Imaging
1487 patients2/09 – 8/09
78%(n=1161)141 hospitals
22%(n=326)
254 patients
50% contained more than 1 study
30% contained more than 1 modality (usually x-ray and CT)
29% decrease(p=0.0004)
Avg #
CT/p
ati
ent
in 2
4 h
rs
1152 CT scans successfully uploaded in 793 patients16% (n=185) repeated within the ED
29% repeated in the pre-implementation cohort
Repeat CT constituted 19% of all CT scans subsequently performed within the ED41% pre-implementation cohort
Importing outside imaging to PACS decreased imaging utilizationReduced repeat imaging
17% for all imaging16% for CT
Decreased Radiation ExposureDecreased Excess Costs