Providing reads of outside images slashes rate of repeat scans

A recent study has shown that providing a formal report for outside images does more than simply offer a second opinion, it leads to a significantly lower chance of repeat imaging.

“Reducing repeat imaging spares patients from unnecessary cost and radiation dose,” wrote Michael T. Lu, MD, of the University of California, San Francisco, and colleagues. “Institutions, payers, and policy makers should consider supporting this practice.”

The results were published in the July issue of American Journal of Roentgenology.

Lu and colleagues explained that, according to some estimates, review of outside imaging accounts for up to 22 percent of radiologist workload at some tertiary care centers, but most research has focused on discrepancies between initial and subsequent interpretation of outside images. “If the value of providing formal reports for outside imaging is not proven, reimbursement and radiology's ability to provide this service are in jeopardy,” wrote the authors.

To assess the impact of providing outside reads, Lu and colleagues considered cases where a patient had an outside abdominal CT imported to the authors’ PACS from Jan. 1, 2006, through Dec. 31, 2011. This included more than 10,000 patients, with 3,719 receiving a formal report on these outside images.

Patients whose outside images got a formal report were 32 percent less likely than others to undergo repeat imaging. After controlling for variables such as the age of the outside study, the odds of repeat imaging remained significantly lower for patients who received a formal report.

Lu and colleagues suggested that providing a formal review of outside images could be a way of cutting into the rate of repeat testing after patients are transferred between institutions. “Further studies are necessary to establish the cost-effectiveness of formal reports for outside imaging. Cost-effectiveness analyses should incorporate the cost and radiation dose savings from reduced repeat imaging, the cost of interpretation, reduced delay to treatment, and changes in diagnosis and management.”