Regional PACS Network Use Tied to Lower Repeat Rates, Costs, and Less Radiation Exposure

According to new research, using a combination of the Internet and compact discs (CDs) to transfer images during interhospital transfer is linked with much lower repeat imaging rates, suggesting that regional picture archiving and communication system (PACS) networks may be useful for reducing cost and radiation exposure associated with trauma.

The establishment of regional trauma systems where patients are transferred from nontertiary emergency departments (EDs) to major trauma centers has been shown to improve survival. Transfer patients are often critically ill, with higher mortality rates and longer hospital stays than patients who undergo treatment at the hospital of first arrival. However, imaging utilization, especially computed tomography (CT) scans and X-rays, on transferred patients may be considered high.

“The purpose of our study was to evaluate the use of the Internet and immediate CD importation to transfer images to a level I regional trauma center on imaging repeat rate, cost, and radiation dose and compare this with previously published repeat rates, all of which are from trauma centers without the capability to electronically transfer images,” said Martin L. Gunn, MBChB, associate professor, body imaging and emergency radiology at the University of Washington (Seattle, WA, USAand author of the study.

Five hundred consecutive trauma patients transferred to a level I trauma center were included in the study. Images were transferred from an outside facility to the trauma center using the Internet and CDs and uploaded to the trauma center’s PACS. Repeat rate, costs, and radiation doses of transferred and repeated CT scans were calculated.

Four hundred ninety-one patients met the inclusion criteria. Three hundred eighty-three patients had 852 CT studies and 380 nonextremity X-rays imported into the trauma center’s PACS. At the trauma center, 494 completion CT scans and 2,924 X-ray studies were performed on these patients. Sixty-nine repeat CT scans were performed on 55 patients, equaling a 17% repeat rate. The total value of imported studies was USD 244,373.69. Repeat imaging totaled USD 20,494.95.

“Our study shows that repeat rates using electronic transfer of imaging are lower than those in the literature and that because of this, patients are exposed to less radiation and the imaging charges are lower to the healthcare system as a whole,” concluded Dr. Gunn. “Further studies to evaluate the effect of this technology on transfer time and patient morbidity and mortality are necessary to accurately determine the full impact on healthcare costs and outcomes.”

The study’s findings were published in the September 2012 issue of the Journal of the American College of Radiology.

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