Jonathan Wang MD, Presenter: Nothing to Disclose

Aaron David Sodickson MD, PhD, Abstract Co-Author: Nothing to Disclose

Ramin Khorasani MD, Abstract Co-Author: Stockholder, Medicalis Corp Global Advisory Board, General Electric Company Global Advisory Board, EMC Corp Medical Advisory Board, Medicalis Corp

Katherine P. Andriole PhD, Abstract Co-Author: Medical Advisory Board, General Electric Company Medical Advisory Board, TeraMedica, Inc

Interpretation of outside hospital imaging studies for ED patients transferred with CD's is impeded by CD viewing programs which often have unfamiliar interfaces, may be viewed on non-diagnostic monitors, and can limit comparison with local prior exams. Importing these studies into PACS would improve workflow and enable enterprise distribution and archival. The goal of this study was to test a distributed CD import solution at the point-of-care to determine feasibility in an acute ED setting.

50 outside hospital imaging CD's were obtained at random from the film library. Time to complete study availability was measured on a standard hospital-build PC for two methods: 1) CD-viewing using only the included CD DICOM viewer application and 2) CD-import to PACS by creating an order in IDXRad RIS, reconciling the DICOM header and importing the study into Centricity PACS (GE Healthcare, USA) using OpenLiteBox (Sorna Corp, MN). Compliance, risk management and medicolegal issues were addressed in a previous study.

47 of the 50 CD’s could be loaded using both the CD-viewing and CD-import methods. 70% of CD’s included CT. Number of images ranged from 1-1983 with study sizes ranging from 1-636 MBytes. Time to study availability ranged from 0.7-15.5 (mean 4.1) minutes using CD-viewing and 0.4-23.5 (mean 7.5) minutes using CD-import. The percent of studies available by 5, 10 and 15 minutes was 68%, 97% and 100% respectively for CD-viewing and 49%, 85% and 96% respectively for CD-import. Additional time for CD-import compared with CD-viewing was <= 5, <= 10 and <= 15 minutes in 70%, 89% and 98% of studies, respectively.

Import of outside hospital imaging from CD to PACS slightly delays time to complete study availability and further work is needed to improve CD import times. However, even with our existing methodology, these delays are modest in comparison to the benefits of radiologist familiarity and efficiency, and the patient care advantages of enterprise distribution and permanent archival. Transfer studies may be viewed purely on PACS after CD import is performed by ancillary personnel. Work is underway to further explore these issues in the live clinical environment.

Technology solutions exist to allow point-of-care outside hospital CD import into PACS, on a timeframe suitable in the ED environment.

Wang, J, Sodickson, A, Khorasani, R, Andriole, K, CD to PACS: Feasibility of Outside Hospital Imaging Import for the Emergency Department.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6019684.html