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

TitleImage Sharing Technologies and Reduction of Imaging Utilization: A Systematic Review and Meta-analysis.
Publication TypeJournal Article
Year of Publication2015
AuthorsVest JR, Jung H-Y, Ostrovsky A, Das LTanmoy, McGinty GB
JournalJ Am Coll Radiol
Volume12
Issue12 Pt B
Pagination1371-1379.e3
Date Published2015 Dec
ISSN1558-349X
KeywordsDiagnostic Imaging, Efficiency, Organizational, Electronic Health Records, Hospital Shared Services, Internationality, Medical Overuse, Radiology Information Systems, Utilization Review
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.

DOI10.1016/j.jacr.2015.09.014
Alternate JournalJ Am Coll Radiol
PubMed ID26614882
PubMed Central IDPMC4730956
Grant ListT32 AG023482 / AG / NIA NIH HHS / United States
Category: 
Faculty Publication