Impact of electronic imaging on clinician behavior in the urgent care setting

Although it is intuitively valuable that more expedient delivery of radiogr aphic images and reports to clinicians would improve patient care, it is im portant to document these outcomes to validate further advances in these ar eas. We evaluated the care of 215 patients seen at a walk-in clinic to dete rmine what benefit digital imaging is to the patient. Cohorts consisted of all patients for whom specified radiology examinations were ordered during a 7-day period. The first cohort was recruited when analog films were used. The second cohort received examinations performed with computed radiograph y (CR) acquisition and computer display, which had been in use for 2 years. Patients were categorized as to the type of study they received, as well a s whether a staff radiologist was immediately available to read the study. Clinical behavior was characterized by outcome measures of time to final di agnosis, time to final treatment, and need for follow-up. Our analysis demo nstrated a reduction in time to final diagnosis that was better appreciated during the times when a staff radiologist was not immediately available. I t also suggested that greater time reductions were seen for patients who re ceived extremity examinations than those who received chest, sinus, or rib films. These data suggest that digital imaging is a useful tool to improve clinical outcome of patients seen in the acute care setting, Copyright (C) 1999 by W.B. Saunders Company.