Image Sharing Technologies and Reduction of Imaging Utilization: A Systematic Review and Meta-analysis

Abstract

Introduction Image sharing technologies may reduce unneeded imaging by improving provider access to imaging information. A systematic review and meta-analysis were conducted to summarize the impact of image sharing technologies on patient imaging utilization. Methods Quantitative evaluations of the effects of PACS, regional image exchange networks, interoperable electronic heath records, tools for importing physical media, and health information exchange systems on utilization were identified through a systematic review of the published and gray English-language literature (2004–2014). Outcomes, standard effect sizes (ESs), settings, technology, populations, and risk of bias were abstracted from each study. The impact of image sharing technologies was summarized with random-effects meta-analysis and meta-regression models. Results A total of 17 articles were included in the review, with a total of 42 different studies. Image sharing technology was associated with a significant decrease in repeat imaging (pooled effect size [ES] = −0.17; 95% confidence interval [CI] = [−0.25, −0.09]; P < .001). However, image sharing technology was associated with a significant increase in any imaging utilization (pooled ES = 0.20; 95% CI = [0.07, 0.32]; P = .002). For all outcomes combined, image sharing technology was not associated with utilization. Most studies were at risk for bias. Conclusions Image sharing technology was associated with reductions in repeat and unnecessary imaging, in both the overall literature and the most-rigorous studies. Stronger evidence is needed to further explore the role of specific technologies and their potential impact on various modalities, patient populations, and settings.

Users’ Perspectives on a Picture Archiving and Communication System (PACS): An In-Depth Study in a Teaching Hospital in Kuwait

“…The study found that the technologists were more satisfied than the radiologists, concerning their current PACS use, attributing their satisfaction to 2 reasons, which had been confirmed in previous studies [ 2 , 6 , 23 ]: the technologists achieved their core objectives of using the PACS, including image access, storage, and retrieval and (2) the radiologists looked beyond these features for additional facilities and functions, such as the PACS being packaged with CAD, teleradiology, or speech recognition functions. As the radiologists had been using the PACS far longer than the technologists had, their understanding and familiarity with the PACS appeared to be relatively higher.…”

“…A PACS could be defined as “an electronic information system (IS) used to acquire, store, transmit, and display medical images” [ 1 ]. Using PACS in hospitals has innumerable benefits at various levels [ 2 ]. At the management level, this technology has direct implications for cost reduction, rendering the film production process redundant.…”

Endovascular Therapy of Vascular Trauma—Current Options and Review of the Literature

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Radiology Support, Communication, and Alignment Network and Its Role to Promote Health Equity in the Delivery of Radiology Care

“…Although virtually every center offered next-day service when presented with a commercial insurance plan, only 6 of the 17 centers would accept him with Medicaid and would only schedule such a study within 2 to 3 weeks [34]. Repeat imaging rates are higher in regions without image-sharing technologies [35]. These regions are often associated with fragmented care with disparate providers for patients of lower socioeconomic status [36].…”