title: Patient safety and image transfer between referring hospitals and neuroscience centres: could we do better?
abstract: BACKGROUND
  District general hospital scanners have historically been linked to regional neuroscience units for specialist opinions on scans and to make decisions on transfer of patients requiring neurosurgical management. The implementation of digital picture archiving and communication systems (PACS) in all hospitals in the UK has disrupted these dedicated links and technical and information governance issues have delayed reprovision of electronic transfer of images for rapid expert decision making in this group of patients. We studied improvement in image transfer to acute neurosurgery units over a 4-year period.
  
  
  METHODS
  Four-year sequential review of national provision of image transfer facilities into neurosurgery units; observational study of delays associated with image transfer modalities in one representative tertiary referral centre.
  
  
  RESULTS
  During the 4 years of study, all hospitals nationally have implemented digital PACS systems for image viewing. Remote image viewing facilities have gradually changed with dedicated image links being replaced by remote PACS access. However, a minority of referrals (12%) still require images to be physically transferred between hospitals using couriers for CD-ROMs. The detailed study within our own unit shows that this adds a mean delay of 5.8 h to decision making.
  
  
  CONCLUSIONS
  Image transfer in neuroscience has been neglected following the shift to PACS servers. The recommendations of the 2004 Neuroscience Critical Care Report are unmet and patient safety is being threatened by a continued failure to implement a coordinated solution to this problem.
authors: Academic Neurosurgery Unit, St George's University of London, London, SW17 0RE, UK. mjncrocker@gmail.com
authors: Matthew
authors: M
authors: Crocker
authors: William B
authors: WB
authors: Cato-Addison
authors: Suresh
authors: S
authors: Pushpananthan
authors: Timothy L
authors: TL
authors: Jones
authors: Joanna
authors: J
authors: Anderson
authors: B Anthony
authors: BA
authors: Bell
mesh_terms: D000328:Adult; D003195:Computer Communication Networks / Q000295:instrumentation / Q000592:standards*; D003625:Data Collection / Q000592:standards; D005260:Female; D006761:Hospitals; D006801:Humans; D008297:Male; D009488:Neurosciences; D010347:Patient Care Planning / Q000592:standards*; D010360:Patient Transfer; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000295:instrumentation / Q000592:standards*; D012017:Referral and Consultation / Q000592:standards*; D019112:Teleradiology / Q000592:standards*; D006113:United Kingdom / Q000453:epidemiology