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Pediatric Trauma Transfer Imaging Inefficiencies—Opportunities for Improvement with Cloud Technology

1 Saint Louis University College of Public Health and Social Justice, Saint Louis, MO, USA
2 Saint Louis University School of Medicine, Saint Louis, MO, USA

BACKGROUND: This study examines the inefficiencies of radiologic imaging transfers from one hospital to the other during pediatric trauma transfers in an era of cloud based information sharing. METHODS: Retrospective review of all patients transferred to a pediatric trauma center from 2008–2014 was performed. Imaging was reviewed for whether imaging accompanied the patient, whether imaging was able to be uploaded onto computer for records, whether imaging had to be repeated, and whether imaging obtained at outside hospitals (OSH) was done per universal pediatric trauma guidelines. RESULTS: Of the 1761 patients retrospectively reviewed, 559 met our inclusion criteria. Imaging was sent with the patient 87.7% of the time. Imaging was unable to be uploaded 31.9% of the time. CT imaging had to be repeated 1.8% of the time. CT scan was not done per universal pediatric trauma guidelines 1.2% of the time. CONCLUSION: Our study demonstrated that current imaging transfer is inefficient, leads to excess ionizing radiation, and increased healthcare costs. Universal implementation of cloud based radiology has the potential to eliminate excess ionizing radiation to children, improve patient care, and save cost to healthcare system.
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1. Berkseth TJ, Mathiason MA, Jafari ME, et al. (2014) Consequences of increased use of computed tomography imaging for trauma patients in rural referring hospitals prior to transfer to a regional trauma centre. Injury 45(5):835-9.

2. Benedict LA, Paulus JK, Rideout L, et al. (2014) Are CT scans obtained at referring institutions justified prior to transfer to a pediatric trauma center? J Ped sur 49(1):184-7; discussion 7-8.

3. Moore HB, Loomis SB, Destigter KK, et al. (2013) Airway, breathing, computed tomographic scanning: duplicate computed tomographic imaging after transfer to trauma center. J Trauma Acute Care Sur 74(3):813-7.

4. Chatoorgoon K, Huezo K, Rangel E, et al. (2010) Unnecessary imaging, not hospital distance, or transportation mode impacts delays in the transfer of injured children. Ped Eemergency Care 26(7):481-6.

5. Lee CY, Bernard AC, Fryman L, et al. (2008) Imaging may delay transfer of rural trauma victims: a survey of referring physicians. J Ttrauma 65(6):1359-63.

6. Chwals WJ, Robinson AV, Sivit CJ, et al. (2008) Computed tomography before transfer to a level I pediatric trauma center risks duplication with associated increased radiation exposure. J Ped Sur 43(12):2268-72.

7. Tepper B, Brice JH, Hobgood CD. (2013) Evaluation of radiation exposure to pediatric trauma patients. J Emergency Med 44(3):646-52.

8. Talati RK, Dunkin J, Parikh S, et al. (2013) Current methods of monitoring radiation exposure from CT. J Am College Radi 10(9):702-7.

9. Adair LS, Ledermann E. (2012) Our path to a filmless future. J Dig Imag 25(1):78-80.

10. Fucic, A, Brunborg G, Lasan R, et al. (2008). Genomic damage in children accidentally exposed to ionizing radiation: a review of the literature. Mutat Res 658(1-2): 111-123.    

11. Hutchinson L. (2014) Imaging: reducing ionizing radiation in children and adolescents. Nat Rev Clin Oncol 11(4): 178.

12. Kaste SC. (2009) Imaging challenges: a US perspective on controlling exposure to ionizing radiation in children with cancer. Ped Rad 39 Suppl 1: S74-79.

13. Lindgren E, Pershagen G. (1992) [Ionizing radiation, magnetic fields and cancer in children]. Lakartidningen 89(50): 4343-4344.

14. Sutow WW, Conard RA. (1965) Effects of ionizing radiation in children. J Pediatr; 67(4): 658-673.

15. Tahir D. (2014) Proponents see cloud technology transforming radiology. Mod Healthc 44(40): 17-18.

16. Gerard P, Kapadia N, Chang PT, et al. (2013) Extended outlook: description, utilization, and daily applications of cloud technology in radiology. Am J Roentgenol 201(6): W809-811.

17. Patel RP. (2012) Cloud computing and virtualization technology in radiology. Clin Radiol 67(11): 1095-1100.

18. Hawkins F. (2002) Putting the EHR to the test. J AHIMA 73(8): 65-66.

19. Protti D. (2003) Issues, musings and trends IT & EHR governance: who should the leaders be? Healthc Manage Forum 16(1): 40-42.

20. Blair J. (2003) EHR trends and challenges. MRI's survey finds workflow and record access among top IT-manager concerns. Healthc Inform 20(11): 56-58.

21. Kluge EH. (2004) Informed consent and the security of the electronic health record (EHR): some policy considerations. Int J Med Inform 73(3): 229-234.

22. Abbas A, Khan SU. (2014) "A review on the state-of-the-art privacy-preserving approaches in the e-health clouds. IEEE J Biomed Health Inform 18(4):1431-41.

23. Rodrigues JJ, de la Torre I, Fernández G, et al. (2013) Analysis of the security and privacy requirements of cloud-based electronic health records systems. J Med Internet Res 15(8):186. Pubmed Central PMCID: 3757992

24. Amatayakul M. (2004) The path to EHR. Healthc Financ Manage 58(8): 98-99.

25. Payne TH, Corley S, Cullen TA, et al. (2015) Report of the AMIA EHR 2020 Task Force on the Status and Future Direction of EHRs. J Am Med Inform Assoc 22(5):1102-10.

Copyright Info: © 2016, Yana Puckett, et al., licensee AIMS Press. This is an open access article distributed under the terms of the Creative Commons Attribution Licese (http://creativecommons.org/licenses/by/4.0)

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