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Viewing Imaging Studies: How Patient Location and Imaging Site Affect Referring Physicians

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Abstract

The purpose of this study was to assess if clinical indications, patient location, and imaging sites predict the viewing pattern of referring physicians for CT and MR of the head, chest, and abdomen. Our study included 166,953 CT/MR images of head/chest/abdomen in 2016–2017 in the outpatient (OP, n = 83,981 CT/MR), inpatient (IP, n = 51,052), and emergency (ED, n = 31,920) settings. There were 125,329 CT/MR performed in the hospital setting and 41,624 in one of the nine off-campus locations. We extracted information regarding body region (head/chest/abdomen), patient location, and imaging site from the electronic medical records (EPIC). We recorded clinical indications and the number of times referring physicians viewed CT/MR (defined as the number of separate views of imaging in the EPIC). Data were analyzed with the Microsoft SQL and SPSS statistical software. About 33% of IP CT and MR studies are viewed > 6 times compared to 7% for OP and 19% of ED studies (p < 0.001). Conversely, most OP studies (55%) were viewed 1–2 times only, compared to 21% for IP and 38% for ED studies (p < 0.001). In-hospital exams are viewed (≥ 6 views; 39% studies) more frequently than off-campus imaging (≥ 6 views; 17% studies) (p < 0.001). For head CT/MR, certain clinical indications (i.e., stroke) had higher viewing rates compared to other clinical indications such as malignancy, headache, and dizziness. Conversely, for chest CT, dyspnea-hypoxia had much higher viewing rates (> 6 times) in IP (55%) and ED (46%) than in OP settings (22%). Patient location and imaging site regardless of clinical indications have a profound effect on viewing patterns of referring physicians. Understanding viewing patterns of the referring physicians can help guide interpretation priorities and finding communication for imaging exams based on patient location, imaging site, and clinical indications. The information can help in the efficient delivery of patient care.

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Funding

One study co-author (MKK) received research grants from Siemens Healthineers and Riverain Inc. for unrelated research.

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Authors and Affiliations

  1. Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 75 Blossom Court, Room 248, Boston, MA, 02114, USA

    Fatemeh Homayounieh, Ramandeep Singh, Subba R. Digumarthy, Keith J. Dreyer & Mannudeep K. Kalra

  2. Department of Data Sciences, Dana-Farber Cancer Institute, Boston, MA, USA

    Tianqi Chen

  3. Department of Information Systems, Partners HealthCare System, Boston, MA, USA

    Ellen J. Sugarman & Thomas J. Schultz

Authors
  1. Fatemeh Homayounieh
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  2. Ramandeep Singh
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  3. Tianqi Chen
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  4. Ellen J. Sugarman
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  5. Thomas J. Schultz
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  6. Subba R. Digumarthy
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  7. Keith J. Dreyer
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  8. Mannudeep K. Kalra
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Corresponding author

Correspondence to Fatemeh Homayounieh.

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This retrospective, quality assurance study was exempted from Institutional Review Board approval and used de-identified patient information.

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The authors declare that they have no conflict of interest.

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Homayounieh, F., Singh, R., Chen, T. et al. Viewing Imaging Studies: How Patient Location and Imaging Site Affect Referring Physicians. J Digit Imaging 33, 334–340 (2020). https://doi.org/10.1007/s10278-019-00279-z

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  • DOI: https://doi.org/10.1007/s10278-019-00279-z

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