Does improved access to diagnostic imaging results reduce hospital length of stay? A retrospective study.
BACKGROUND
One year after the introduction of Information and Communication Technology (ICT) to support diagnostic imaging at our hospital, clinicians had faster and better access to radiology reports and images; direct access to Computed Tomography (CT) reports in the Electronic Medical Record (EMR) was particularly popular. The objective of this study was to determine whether improvements in radiology reporting and clinical access to diagnostic imaging information one year after the ICT introduction were associated with a reduction in the length of patients' hospital stays (LOS).


METHODS
Data describing hospital stays and diagnostic imaging were collected retrospectively from the EMR during periods of equal duration before and one year after the introduction of ICT. The post-ICT period was chosen because of the documented improvement in clinical access to radiology results during that period. The data set was randomly split into an exploratory part used to establish the hypotheses, and a confirmatory part. The data was used to compare the pre-ICT and post-ICT status, but also to compare differences between groups.


RESULTS
There was no general reduction in LOS one year after ICT introduction. However, there was a 25% reduction for one group - patients with CT scans. This group was heterogeneous, covering 445 different primary discharge diagnoses. Analyses of subgroups were performed to reduce the impact of this divergence.


CONCLUSIONS
Our results did not indicate that improved access to radiology results reduced the patients' LOS. There was, however, a significant reduction in LOS for patients undergoing CT scans. Given the clinicians' interest in CT reports and the results of the subgroup analyses, it is likely that improved access to CT reports contributed to this reduction.
Hurlen
Petter
P
Helse Sør-Øst Health Services Research Centre Akershus University Hospital, NO-1478 Lørenskog, Norway. petter@hurlen.no
Østbye
Truls
T
Borthne
Arne S
AS
Gulbrandsen
Pål
P
D003195:Computer Communication Networks / Q000458:organization & administration; D016208:Databases, Factual; D003952:Diagnostic Imaging / Q000706:statistics & numerical data*; D057286:Electronic Health Records; D005260:Female; D006751:Hospital Information Systems / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D009664:Norway; D017063:Outcome Assessment, Health Care; D011361:Professional Competence; D015397:Program Evaluation; D011873:Radiology Information Systems / Q000458:organization & administration; D012189:Retrospective Studies; D018570:Risk Assessment; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data
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