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Regional PACS Network Use Tied to Lower Repeat Rates, Costs, and Less Radiation Exposure

By MedImaging International staff writers
Posted on 10 Sep 2012

According to new research, using a combination of the Internet and compact discs (CDs) to transfer images during interhospital transfer is linked with much lower repeat imaging rates, suggesting that regional picture archiving and communication system (PACS) networks may be useful for reducing cost and radiation exposure associated with trauma.

The establishment of regional trauma systems where patients are transferred from nontertiary emergency departments (EDs) to major trauma centers has been shown to improve survival. Transfer patients are often critically ill, with higher mortality rates and longer hospital stays than patients who undergo treatment at the hospital of first arrival. However, imaging utilization, especially computed tomography (CT) scans and X-rays, on transferred patients may be considered high.

“The purpose of our study was to evaluate the use of the Internet and immediate CD importation to transfer images to a level I regional trauma center on imaging repeat rate, cost, and radiation dose and compare this with previously published repeat rates, all of which are from trauma centers without the capability to electronically transfer images,” said Martin L. Gunn, MBChB, associate professor, body imaging and emergency radiology at the University of Washington (Seattle, WA, USAand author of the study.

Five hundred consecutive trauma patients transferred to a level I trauma center were included in the study. Images were transferred from an outside facility to the trauma center using the Internet and CDs and uploaded to the trauma center’s PACS. Repeat rate, costs, and radiation doses of transferred and repeated CT scans were calculated.

Four hundred ninety-one patients met the inclusion criteria. Three hundred eighty-three patients had 852 CT studies and 380 nonextremity X-rays imported into the trauma center’s PACS. At the trauma center, 494 completion CT scans and 2,924 X-ray studies were performed on these patients. Sixty-nine repeat CT scans were performed on 55 patients, equaling a 17% repeat rate. The total value of imported studies was USD 244,373.69. Repeat imaging totaled USD 20,494.95.

“Our study shows that repeat rates using electronic transfer of imaging are lower than those in the literature and that because of this, patients are exposed to less radiation and the imaging charges are lower to the healthcare system as a whole,” concluded Dr. Gunn. “Further studies to evaluate the effect of this technology on transfer time and patient morbidity and mortality are necessary to accurately determine the full impact on healthcare costs and outcomes.”

The study’s findings were published in the September 2012 issue of the Journal of the American College of Radiology.

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69 (44.107437133789): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=216 ORDER BY `ordering`

70 (463.96255493164): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294742455 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (537.87231445312): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294742455 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (39.100646972656): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (47.922134399414): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (43.153762817383): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294742455 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (39.100646972656): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294742455 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (36.001205444336): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (88.930130004883): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (46.968460083008): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (39.815902709961): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (38.14697265625): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (51.021575927734): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (80.108642578125): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742455 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742455 AND published='1' LIMIT 1

105 (56.028366088867): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742455 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742455 AND published='1' LIMIT 1

106 (51.021575927734): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294742455 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (56.982040405273): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294742455 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (72.002410888672): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742455 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742455 AND published='1' LIMIT 1

109 (44.107437133789): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742455 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742455 AND published='1' LIMIT 1

110 (55.074691772461): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294742455 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (549.0779876709): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294742455 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (697.13592529297): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (459.90943908691): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (152.1110534668): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742455 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742455 AND published='1' LIMIT 1

115 (77.009201049805): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742455 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742455 AND published='1' LIMIT 1

116 (129.93812561035): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742455 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742455 AND published='1' LIMIT 1

117 (56.982040405273): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742455 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742455 AND published='1' LIMIT 1

118 (142.81272888184): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742455 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742455 AND published='1' LIMIT 1

119 (55.074691772461): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742455 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742455 AND published='1' LIMIT 1

120 (284.91020202637): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

121 (!!!!! 23366.928100586): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

122 (106.0962677002): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742455 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742455 AND published='1' LIMIT 1

123 (46.968460083008): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742455 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742455 AND published='1' LIMIT 1

124 (478.98292541504): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294742455 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294742455 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 749529.12330627): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (!!!!! 1019514.0838623): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (195.02639770508): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

128 (113.96408081055): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

129 (62.942504882812): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

130 (49.829483032227): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

131 (82.969665527344): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

132 (62.942504882812): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

133 (467.06199645996): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742455 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

134 (310.18257141113): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742455 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

135 (185.01281738281): SELECT name FROM jos_deeppockets WHERE id=216

136 (32.186508178711): SELECT name FROM jos_deeppockets WHERE id=216

137 (421.04721069336): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))216((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

138 (403.88107299805): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))216((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

139 (957.01217651367): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742455 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742455 AND published='1' LIMIT 1

140 (49.829483032227): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742455 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742455 AND published='1' LIMIT 1

141 (!!!!! 6314.9929046631): TRUNCATE TABLE jos_trademed_module

142 (316.14303588867): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294742455 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

143 (468.96934509277): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294742455 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

144 (298.02322387695): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742455 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

145 (56.982040405273): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742455 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

146 (72.002410888672): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742455 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742455 AND published='1' LIMIT 1

147 (64.849853515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742455 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742455 AND published='1' LIMIT 1

148 (!!!!! 1033.0677032471): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

149 (60.081481933594): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742455 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742455 AND published='1' LIMIT 1

150 (43.869018554688): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742455 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742455 AND published='1' LIMIT 1

151 (397.92060852051): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294742455 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294742455 AND type='deeppockets_item' AND published='1' LIMIT 1

152 (37.908554077148): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=216 or channel_id is null)

153 (28.133392333984): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=216 or channel_id is null)

154 (31.948089599609): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

155 (57.93571472168): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742455 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742455 AND published='1' LIMIT 1

156 (49.114227294922): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742455 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742455 AND published='1' LIMIT 1

157 (174.99923706055): select jos_twitters.link from jos_twitters where cat=10

158 (44.822692871094): select jos_facebook.link from jos_facebook where cat=10

159 (49.114227294922): select jos_google_plus.link from jos_google_plus where cat=10

160 (28.133392333984): select jos_linkedin.link from jos_linkedin where cat=10

161 (297.06954956055): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

162 (!!!!! 1279.1156768799): insert into jos_banners_delta values (14615,'2025-06-18 23:34:25','216.73.216.120','view'),(14202,'2025-06-18 23:34:25','216.73.216.120','view'),(14203,'2025-06-18 23:34:25','216.73.216.120','view')

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