title: Providers' Access of Imaging Versus Only Reports: A System Log File Analysis.
abstract: BACKGROUND
  An increasing number of technologies allow providers to access the results of imaging studies. This study examined differences in access of radiology images compared with text-only reports through a health information exchange system by health care professionals.
  
  
  METHODS
  The study sample included 157,256 historical sessions from a health information exchange system that enabled 1,670 physicians and non-physicians to access text-based reports and imaging over the period 2013 to 2014. The primary outcome was an indicator of access of an imaging study instead of access of a text-only report. Multilevel mixed-effects regression models were used to estimate the association between provider and session characteristics and access of images compared with text-only reports.
  
  
  RESULTS
  Compared with primary care physicians, specialists had an 18% higher probability of accessing actual images instead of text-only reports (β = 0.18; P < .001). Compared with primary care practice settings, the probability of accessing images was 4% higher for specialty care practices (P < .05) and 8% lower for emergency departments (P < .05). Radiologists, orthopedists, and neurologists accounted for 79% of all the sessions with actual images accessed. Orthopedists, radiologists, surgeons, and pulmonary disease specialists accessed imaging more often than text-based reports only.
  
  
  CONCLUSIONS
  Consideration for differences in the need to access images compared with text-only reports based on the type of provider and setting of care are needed to maximize the benefits of image sharing for patient care.
authors.affiliation: Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, New York.
authors.forename: Hye-Young
authors.initials: HY
authors.lastname: Jung
authors.affiliation: Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: Judy Wawira
authors.initials: JW
authors.lastname: Gichoya
authors.affiliation: Department of Healthcare Policy & Management, Indiana University Richard M. Fairbanks School of Public Health at IUPUI, Indianapolis, Indiana; Regenstrief Institute, Inc, Indianapolis, Indiana. Electronic address: joshvest@iu.edu.
authors.forename: Joshua R
authors.initials: JR
authors.lastname: Vest
mesh_terms: D004282:Documentation / Q000706:statistics & numerical data*; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D066275:Health Information Exchange / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D033181:Information Dissemination / Q000379:methods; D016247:Information Storage and Retrieval / Q000379:methods*; D009518:New York; D000072177:Radiologists / Q000706:statistics & numerical data*; D011873:Radiology Information Systems / Q000706:statistics & numerical data*; D014600:Utilization Review
keywords: Health information technology; computer-assisted; medical specialty; nursing; radiographic image interpretation; radiology; radiology information systems/classification