Radiologists and referring clinicians frequently use CDs and DVDs to review patient medical images (e.g., MRIs and CT scans) acquired at outside imaging centers, but issues regarding access, importability, and viewing of these portable media could negatively affect patient care, according to a study published in the January issue of the Journal of the American College of Radiology.
The report looks at current practices for portable media use for medical imaging in both academic and nonacademic radiology departments in the United States.
Researchers from Johns Hopkins University in Baltimore reviewed a 22-question survey of members of the Association of Administrators in Academic Radiology, the Association for Medical Imaging Management, and the University HealthSystem Consortium.
The 102 responses revealed three problem areas regarding portable media: access, importability, and viewing issues. Other major issues included noncompliance with the Digital Imaging and Communications in Medicine (DICOM) standard and/or corresponding Integrating the Healthcare Enterprise (IHE) profile, and a lack of knowledge about compliance.
Ninety-eight percent of respondents said that their institutions produced DICOM-compliant media; 2.0% were uncertain. However, only 22.2% of respondents claimed their institutions produced IHE Portable Data for Imaging (PDI)-compliant media, while 71.6% were uncertain.
Only 16% of respondents' institutions routinely tested for DICOM and IHE PDI compliance. "We were quite surprised to learn that only a few facilities routinely tested their media," says Katarzyna J. Macura, MD, PhD, Department of Radiology and Radiological Science at Johns Hopkins, an author of the study.
The survey didn't explore the "why" behind the low numbers, says Macura. Questions in the survey were designed to establish the status of existing policies on portable media, she explains. They did not ask about the rationale to implement or not implement those policies. "We aimed to learn whether they had any [such policies] and how they were handling portable media."
"We hope to raise awareness of the problem and promote routine media testing, for which several tools do exist," she said.
She and her co-authors offer several recommendations. Among them:
• Radiology practices should routinely generate only DICOM- and IHE PDI- compliant media.
• Radiology practices should make it routine to use only IHE PDI-compliant media and to routinely test for compliance. (Testing of newly created media should be performed on a separate computer.)
• It should also be made routine to review burned media to ensure that all the necessary files are present on the disc and, if applicable, to ensure proper compression techniques (if used) were used before sending images home with patients.
The study, the authors note, illustrates the lack of knowledge about compliance
issues for both DICOM and IHE PDI. They warn that lack of compliance can delay delivery of appropriate clinical or surgical care and could potentially have a detrimental effect on patient outcomes: "The consequences of not taking such action are largely felt by patients who must undergo repeat examinations and incur the associated costs (financial and radiation) and who must schedule more appointments and see more providers."