The gradual change of hospital radiology departments to a picture archive and communication system (PACS) has many proved advantages.1,2,3 However, in our experience, there are also considerable drawbacks. The issues of data storage and comparison of new with old films are recognised (failure to compare with prior films is one of the known risk factors for malpractice in radiology).4 In our experience, the difficulty in transferring images from a referring hospital to a tertiary care centre is worth noting. The apparent inability of each hospital's PACS to communicate with another and the lack of (obtainable) hard copies to send with transferred patients is proving to be a challenge.
Images can be transferred to a disk, but out of hours this is not always possible, and on numerous occasions our computer programs have failed to read the data, resulting in inaccessible images. In the field of neonatal surgery, the radiological progression of diseases such as necrotising enterocolitis is particularly important when considering whether operative intervention is required. The delay and potential need to repeat diagnostic imaging therefore has a deleterious effect on patient care. If imaging is repeated, there is additionally an unnecessary financial burden on the trust.
A potential alternative is to email images, with the patient identifiers removed, from the referring to the receiving clinician. However, these images are often suboptimal and cannot be manipulated—for example, if magnification is required. In addition, the data can be viewed only in the presence of the receiving clinician, which can be a problem with current shift systems.
We would be interested to hear other clinicians' solutions to this problem, which we hope will be solved in the long term by online access or interhospital data transfer strategies. However, recent reports of the difficulties in implementation of “Connecting for Health” suggest that this may not occur for some time.
Footnotes
Competing interests: None declared.
References
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