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Outside Imaging in Emergency Department Transfers

Outside Imaging in Emergency Department Transfers. Jonathan Opraseuth MD Stephen Ledbetter MD MPH Aaron Sodickson MD PhD Emergency Radiology, Brigham and Women’s Hospital, Harvard Medical School Boston, MA. Importation of Imaging into PACS. Streamlined Patient Care.

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Outside Imaging in Emergency Department Transfers

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  1. Outside Imaging in Emergency Department Transfers Jonathan Opraseuth MD Stephen Ledbetter MD MPH Aaron Sodickson MD PhD Emergency Radiology, Brigham and Women’s Hospital, Harvard Medical School Boston, MA

  2. Importation of Imaging into PACS Streamlined Patient Care • 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

  3. Material and Methods • Compared Subsequent Imaging • All study types, and CT specifically • All locations, and ED specifically • Repeat and Additional Imaging

  4. Results 1487 patients 2/09 – 8/09 254 patients 78% (n=1161) 141 hospitals 22% (n=326)

  5. Results 50% contained more than 1 study 30% contained more than 1 modality (usually x-ray and CT)

  6. Comparing Successful Imports to Failed Imports

  7. Focusing Specifically on CT 29% decrease (p=0.0004) Avg # CT/patient in 24 hrs

  8. Repeat Imaging • 1152 CT scans successfully uploaded in 793 patients • 16% (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 ED • 41% pre-implementation cohort

  9. Conclusions • Importing outside imaging to PACS  decreased imaging utilization • Reduced repeat imaging • 17% for all imaging • 16% for CT Decreased Radiation Exposure Decreased Excess Costs

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