Appl Clin Inform 2012; 03(04): 475-487
DOI: 10.4338/ACI-2012-06-RA-0022
Research Article
Schattauer GmbH

Insight into the Sharing of Medical Images

Physician, Other Health Care Providers, and Staff Experience in a Variety of Medical Settings
J.C. Sandberg
1   Department of Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
,
Y. Ge
2   Department of Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem, NC, USA
,
H.T. Nguyen
1   Department of Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
,
T.A. Arcury
1   Department of Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
,
A.J. Johnson
3   Department of Radiology, Wake Forest School of Medicine, Winston-Salem, NC, USA
,
W. Hwang
4   Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, USA
,
H.D. Gage
3   Department of Radiology, Wake Forest School of Medicine, Winston-Salem, NC, USA
,
T. Reynolds
5   Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
,
J.J. Carr
3   Department of Radiology, Wake Forest School of Medicine, Winston-Salem, NC, USA
› Author Affiliations
Further Information

Publication History

Received 18 June 2012

Accepted 11 November 2012

Publication Date:
19 December 2017 (online)

Summary

Background: Scant knowledge exists describing health care providers’ and staffs’ experiences sharing imaging studies. Additional research is needed to determine the extent to which imaging studies are shared in diverse health care settings, and the extent to which provider or practice characteristics are associated with barriers to viewing external imaging studies on portable media.

Objective: This analysis uses qualitative data to 1) examine how providers and their staff accessed outside medical imaging studies, 2) examine whether use or the desire to use imaging studies conducted at outside facilities varied by provider specialty or location (urban, suburban, and small town) and 3) delineate difficulties experienced by providers or staff as they attempted to view and use imaging studies available on portable media.

Methods: Semi-structured interviews were conducted with 85 health care providers and medical facility staff from urban, suburban, and small town medical practices in North Carolina and Virginia. The interviews were audio recorded, transcribed, then systematically analyzed using ATLAS.ti.

Results: Physicians at family and pediatric medicine practices rely primarily on written reports for medical studies other than X-rays; and thus do not report difficulties accessing outside imaging studies. Subspecialists in urban, suburban, and small towns view imaging studies through internal communication systems, internet portals, or portable media. Many subspecialists and their staff report experiencing difficulty and time delays in accessing and using imaging studies on portable media.

Conclusion: Subspecialists have distinct needs for viewing imaging studies that are not shared by typical primary care providers. As development and implementation of technical strategies to share medical records continue, this variation in need and use should be noted. The sharing and viewing of medical imaging studies on portable media is often inefficient and fails to meet the needs of many subspeciality physicians, and can lead to repeated imaging studies.

Citation: Sandberg JC, Ge Y, Nguyen HT, Arcury TA, Johnson AJ, Hwang W, Gage HD, Reynolds T, Carr JJ. Insight into the sharing of medical images. Physician, other health care providers, and staff experience in a variety of medical settings. Appl Clin Inf 2012; 3: 475–487

http://dx.doi.org/10.4338/ACI-2012-06-RA-0022

 
  • References

  • 1 Government Accountability Office.. Report to Congressional Requesters: Medicare Part B Imaging Services –Rapid spending growth and shift to physician offices indicate need for CMS to consider additional management practices. Washington, D. C.: GAO; 2008
  • 2 Hricak H, Brenner DJ, Adelstein SJ, Frush DP, Hall EJ, Howell RW. et al. Managing radiation use in medical imaging : a multifaceted challenge. Radiology 2011; 258 (Suppl. 03) 889-905.
  • 3 Hendee WR, Becker GJ, Borgstede JP, Bosma J, Casarella WJ, Erickson BA. et al. Addressing overutilization in medical imaging. Radiology 2010; 257 (Suppl. 01) 240-245.
  • 4 Rao SL, Brammer C, McKethan A, Buntin MB. Health information technology: transforming chronic disease management and care transitions. Prim Care 2012; 39 (Suppl. 02) 327-344.
  • 5 Fontaine P, Zink T, Boyle RG, Kralewski J. Health information exchange: participation by Minnesota primary care practices. Arch Intern Med 2010; 170 (Suppl. 07) 622-629.
  • 6 Fontaine P, Ross SE, Zink T, Schilling LM. Systematic review of health information exchange in primary care practices. J Am Board Fam Med 2010; 23 (Suppl. 05) 655-670.
  • 7 Jha AK, Bates DW, Jenter C, Orav EJ, Zheng J, Cleary P. et al. Electronic health records: use, barriers and satisfaction among physicians who care for black and Hispanic patients. J Eval Clin Pract 2009; 15 (Suppl. 01) 158-163.
  • 8 Simon SR, Kaushal R, Cleary PD, Jenter CA, Volk LA, Poon EG. et al. Correlates of electronic health record adoption in office practices: a statewide survey. J Am Med Inform Assoc 2007; 14 (Suppl. 01) 110-117.
  • 9 Wright A, Soran C, Jenter CA, Volk LA, Bates DW, Simon SR. Physician attitudes toward health information exchange: results of a statewide survey. J Am Med Inform Assoc 2010; 17 (Suppl. 01) 66-70.
  • 10 Patel V, Abramson EL, Edwards A, Malhotra S, Kaushal R. Physicians’ potential use and preferences related to health information exchange. Int J Med Inform 2011; 80 (Suppl. 03) 171-180.
  • 11 Bailey JE, Wan JY, Mabry LM, Landy SH, Pope RA, Waters TM. et al. Does health information exchange reduce unnecessary neuroimaging and improve quality of headache care in the emergency department?. J Gen Inter Med 2012 [Epub ahead of print]
  • 12 Mendelson DS, Bak PRG, Menschik E, Siegel E. Image Exchange: IHE and the Evolution of Image Sharing1. Radiographics 2008; 28 (Suppl. 07) 1817-1833.
  • 13 Cook SH, Fielding JR, Phillips JD. Repeat abdominal computed tomography scans after pediatric blunt abdominal trauma: missed injuries, extra costs, and unnecessary radiation exposure. J Pediatr Surg 2010; 45 (10) 2019-2024.
  • 14 Liepert AE, Cochran A. CT Utilization in Transferred Trauma Patients. J Surg Res 2011; 170 (Suppl. 02) 309-313.
  • 15 Gupta R, Greer SE, Martin ED. Inefficiencies in a rural trauma system: the burden of repeat imaging in interfacility transfers. J Trauma 2010; 69 (Suppl. 02) 253-255.
  • 16 Sodickson A, Opraseuth J, Ledbetter S. Outside imaging in emergency department transfer patients: CD import reduces rates of subsequent imaging utilization. Radiology 2011; 260 (Suppl. 02) 408-413.
  • 17 Lu MT, Tellis WM, Fidelman N, Qayyum A, Avrin DE. Reducing the rate of repeat imaging: import of outside images to PACS. Am J Roentgenol 2012; 198 (Suppl. 03) 628-634.
  • 18 Kalia V, Carrino JA, Macura KJ. Policies and procedures for reviewing medical images from portable media: survey of radiology departments. J Am Coll Radiol 2011; 8 (Suppl. 01) 39-48.
  • 19 Lofland J, Lofland LH. Analyzing Social Settings: A guide to qualitative observation and analysis. 4th ed. Belmont, CA: Wadsworth/Thomson Learning; 2006
  • 20 Ash JS, Guappone KP. Qualitative evaluation of health information exchange efforts. J Biomed Inform 2007; 40 (Suppl. 06) S33-S39.
  • 21 Arcury TA, Gaylord S, Cook HL. Incorporating qualitative methods into the study of health beliefs and health behaviors in rural adults. In: Gesler WM, Rabiner DJ, DeFriese GH, editors. Rural health and aging research. Amityville, NY Baywood Publishing; 1998. p. 109-126
  • 22 Berg BL. Qualitative research methods for the social sciences. Boston, MA: Pearson/Allyn & Bacon; 2007
  • 23 Werner O, Bernard H. Short take 13: Ethnographics sampling. Field Methods 1994; 6: 7-9.
  • 24 Shapiro JS, Kannry J, Kushniruk AW, Kuperman G, Subcomm NCA. Emergency physicians’ perceptions of health information exchange. J Am Med Inform Assoc 2007; 14 (Suppl. 06) 700-705.
  • 25 Fordyce MA, Chen FM, Doescher MP, Hart LG. University of Washington Rural Health Research Center. 2005 Physician supply and distribution in rural areas of the United States. 2007
  • 26 Macura KJ, Carrino JA, Kahn Jr CE. Reviewing images from portable media: an ongoing challenge. J Am Coll Radiol 2009; 6 (Suppl. 01) 61-64.
  • 27 Flanders AE. Medical Image and Data Sharing: Are we there yet?. Radiographics 2009; 29 (Suppl. 05) 1247-1251.
  • 28 Blumenthal D. Launching HITECH. N Engl J Med 2010; 362 (Suppl. 05) 382-385.