Impact of Inter-Hospital Radiologic Image Sharing on Transfer Times and Ultimate Dispositions

Background: When patients are transferred from one hospital to another, federal regulations require that radiologic studies and/or their interpretations be included. Waiting for studies to be copied often delays patient transport. With time-sensitive diagnoses (e.g.., aortic aneurysm, acute stroke, etc), these delays can result in adverse outcomes.

Objective: To implement a program by which radiologic images can be sent to a cloud and immediately downloaded at the receiving institution. This prevents delays in patient transfers and allows the receiving physician to mobilize necessary resources to make timely dispositions based on the imaging obtained from the transferring hospital.

Methods: Emix, a commercial, cloud based, electronic medical information exchange service is compatible with Digital Imaging and Communication Standard for Medical Imaging (DICOM) based image and information management systems. The Patient Transfer Center at Virginia Commonwealth University used Emix uploads for four months as a pilot with two referring hospitals. This study examined the barriers to adoption and utilization of Emix.

Results: In the first four months, 624 images were transferred. Identified barriers included obtaining buy-in from key stakeholders, such as the IT, legal, and compliance departments of the sending facility. Once the system was in place, recurrent education of the referring physicians and their radiology technicians was required to achieve a high level of participation.

Conclusion: Early experience with utilization of Emix has proven beneficial to facilitating rapid patient transfers and for viewing images prior to patient arrival. Within the year, this service will be expanded to all 12 major referring hospitals.