Vest, Joshua R.Jung, Hye-YoungOstrovsky, AaronDas, Lala TanmoyMcGinty, Geraldine B.2017-06-132017-06-132015-12Vest, J. R., Jung, H.-Y., Ostrovsky, A., Das, L. T., & McGinty, G. B. (2015). Image Sharing Technologies and Reduction of Imaging Utilization: A Systematic Review and Meta-analysis. Journal of the American College of Radiology : JACR, 12(12 0 0), 1371–1379.e3. http://doi.org/10.1016/j.jacr.2015.09.014https://hdl.handle.net/1805/12984INTRODUCTION: Image sharing technologies may reduce unneeded imaging by improving provider access to imaging information. A systematic review and meta-analysis were conducted to summarize the impact of image sharing technologies on patient imaging utilization. METHODS: Quantitative evaluations of the effects of PACS, regional image exchange networks, interoperable electronic heath records, tools for importing physical media, and health information exchange systems on utilization were identified through a systematic review of the published and gray English-language literature (2004-2014). Outcomes, standard effect sizes (ESs), settings, technology, populations, and risk of bias were abstracted from each study. The impact of image sharing technologies was summarized with random-effects meta-analysis and meta-regression models. RESULTS: A total of 17 articles were included in the review, with a total of 42 different studies. Image sharing technology was associated with a significant decrease in repeat imaging (pooled effect size [ES] = -0.17; 95% confidence interval [CI] = [-0.25, -0.09]; P < .001). However, image sharing technology was associated with a significant increase in any imaging utilization (pooled ES = 0.20; 95% CI = [0.07, 0.32]; P = .002). For all outcomes combined, image sharing technology was not associated with utilization. Most studies were at risk for bias. CONCLUSIONS: Image sharing technology was associated with reductions in repeat and unnecessary imaging, in both the overall literature and the most-rigorous studies. Stronger evidence is needed to further explore the role of specific technologies and their potential impact on various modalities, patient populations, and settings.en-USPublisher PolicyHealth information exchangeData sharingEvaluationRadiology information systemsUtilizationArticle