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J Am Coll Radiol. 2015 Dec;12(12 Pt B):1371-1379.e3. doi: 10.1016/j.jacr.2015.09.014.

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

Author information

1
Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, New York. Electronic address: joshvest@iu.edu.
2
Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, New York.
3
Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, New York; Greenberg Division of Cardiology, Weill Cornell Medical College, New York, New York.
4
Department of Radiology, Weill Cornell Medical College, New York, New York; New York-Presbyterian Hospital, New York, New York.

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.

KEYWORDS:

Health information exchange; data sharing; evaluation; radiology information systems; utilization

PMID:
26614882
PMCID:
PMC4730956
DOI:
10.1016/j.jacr.2015.09.014
[Indexed for MEDLINE]
Free PMC Article

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