Introduction: Archiving of outside facility diagnostic imaging (OFDI) on the institution’s Picture Archiving Communication and Systems (PACS) servers is not presently an option. However, a significant proportion of patient care is still based on OFDI. The management of this physical media (i.e. CD-ROMs, hard copy films, etc.) is operationally challenging, and can impact the ability of physicians to deliver the highest quality care when films are not available at the point of care. To address this problem, a secure application has been developed to allow the uploading and viewing of OFDI via web-browser.
Methods: A secure web application was designed and integrated into the Emory Neurosurgery Patient Database (ENPD). Open source technologies were used. The application and uploader for images in Digital Imaging and Communications in Medicine (DICOM) format are written in Java, and the back end is powered by DCM4CHEE, a PACS server running on PostgresSQL. The headers within uploaded DICOM files are tagged with unique patient identifiers from the ENPD (when there is an appropriate match), thereby providing an integrated user experience for viewing patient imaging and other data via a single interface. Users with appropriate credentials can log in from any web browser to view and upload OFDI.
Results: A secure web-based solution for patient diagnostic imaging management i) is technically feasible; ii) can potentially eliminate unnecessary repeat imaging and associated costs and patient risk; iii) can decrease the incidence at which OFDI is lost or can not be accessed at critical junctures in patient care (i.e. at surgery); iv) can improve decision making and quality of care provided; and v) can be integrated into the current ENPD.
Conclusions: A secure web-based application capable of uploading and viewing OFDI can eliminate duplicate scans, loss of scan data, and significantly improve medical decision making.
Patient Care: Improves outside facility diagnostic imaging availability at the point of care enabling better patient management and decision making.
Lowers patient risk presented by repeat testing.
Learning Objectives: By the conclusion of this session, participants should be able to: 1) Describe the importance of OFDI availability; 2) Discuss, in small groups the logistical challenges of physical media; 3) Identify a potential solution for the management of OFDI.