Note: This copy is for your personal, non-commercial use only. To order presentation-ready copies for distribution to your colleagues or clients, contact us at www.rsna.org/rsnarights. ORIGINAL RESEARCH n EMERGENCY RADIOLOGY 408 radiology.rsna.org n Radiology: Volume 260: Number 2—August 2011 Outside Imaging in Emergency Department Transfer Patients: CD Import Reduces Rates of Subsequent Imaging Utilization 1 Aaron Sodickson, MD, PhD Jonathan Opraseuth, MD Stephen Ledbetter, MD, MPH Purpose: To test the hypothesis that among emergency department (ED) transfer patients, CD import of outside examina- tions into the picture archiving and communication system (PACS) decreases imaging utilization in the subsequent 24 hours. Materials and Methods: Institutional review board approval was obtained for this HIPAA-compliant study, with waiver of informed consent for retrospective medical records review. In 1487 con- secutive ED patients, CD import to PACS was attempted between February 1 and August 31, 2009. Subsequent rates of imaging performed within 24 hours of any CD import attempt were extracted from the electronic medi- cal record and compared between two patient groups: those with successful CD import and those for whom CD import had failed. Rates of all subsequent imaging and of computed tomographic (CT) imaging alone were com- pared by using the Wilcoxon rank sum test. ED CT utili- zation in the successful-import group was compared with that in a historical control group of 254 consecutive ED patients transferred with outside hospital CDs between August 2007 and January 2008, prior to implementation of import procedures. Results: CD import to PACS was successful in 78% (1161 of 1487) of patients. Successful CD import produced a 17% reduc- tion ( P , .001) in mean rates of all subsequent diagnostic imaging, from 3.30 to 2.74 examinations per patient in the failed-import and successful-import groups, respectively, and a 16% reduction ( P = .01) in subsequent CT utilization from mean of 1.41 to 1.19 scans per patient in those respec- tive groups. Compared with the historical control group, posttransfer utilization of CT in the ED was reduced by 29% ( P , .001) from 1.18 (historical control group) to 0.84 (successful-import group) scans per patient. Conclusion: Among ED transfer patients, CD import of outside imag- ing from the sending institution into the receiving institu- tion’s PACS significantly decreased the rates of subsequent imaging utilization. q RSNA, 2011 1 From the Department of Radiology, Brigham and Women’s Hospital, 75 Francis St, Boston, MA 02115. From the 2010 RSNA Annual Meeting. Received October 6, 2010; revision requested November 11; final revision received January 26, 2011; accepted February 4; final version accepted February 18. Address correspondence to A.S. (e-mail: asodickson@partners.org ). q RSNA, 2011