Teleradiology/PACS usage: A survey of the American Society of Emergency Radiology Membership

The purpose of this study was to assess the use of teleradiology/picture archiving and communications (PACS) systems for emergency patients by members of the American Society of Emergency Radiology (ASER). Results were tabulated from a survey mailed to ASER members in February 1997. The listed percentages are based on the total number of answers to a particular question.ASER members representing 76 medical centers responded to the survey. Forty-five of the centers (59%) were level I trauma centers, and 17 (22%) were level II trauma centers. Forty-five centers (59%) had teleradiology/PACS systems. Another 13 (19%) planned to acquire teleradiology/PACS equipment within a year. In 32 (74%) of the centers with teleradiology/PACS systems, patients with emergency conditions accounted for more than half of the total teleradiology/PACS volume.Teleradiology/PACS systems were utilized for head computed tomographic (CT) examinations in 35 centers (85%), body CT in 34 (81%), ultrasound in 28 (67%), plain radiography in 24 (57%), and magnetic resonance imaging (MRI) in 18 (44%). Final interpretations were made primarily from original films in 23 centers (56%), monitor image in 11 (27%), or both in 7 (17%). The most common uses for the teleradiology/PACS equipment were interpretations of examinations performed at another site within the same center in 24 centers (56%), wet readings from home in 18 (42%), interpretation of examinations from other centers in 25 (59%), and off-hours coverage of practice at another site in 18 (42%).Eleven centers (33%) reported rare or occasional technical limitations to examination interpretation, most commonly relating to loss of resolution or detail on the monitor image, preventing visualization of a finding. Teleradiology/PACS systems have resulted in quicker interpretations in 33 centers (82.5%) and reduced lost film count in 12 (29%).Seventy-eight percent of ASER members’ centers are expected to have teleradiology/PACS equipment within 1 year. Emergency conditions, off-hours coverage, and remote coverage of sites within the centers were the most frequent uses.