How to help providers track every patient’s imaging history

Every patient’s medical history should include a “Past Imaging History” section specifically designed to provide context about their health, according to a new commentary published in Current Problems in Diagnostic Radiology.

“Through the decades, the way a medical history is taken hasn't changed a lot,” wrote Charilaos Tsioulpas, MD, Siena University Hospital in Italy, and colleagues. “However, it has been enhanced with sophisticated tools that have revolutionized our daily practice. We can now see through a patient's body, obtain high definition real-time images, and identify structural, morphologic and functional abnormalities.”

This, according to Tsioulpas et al., is where Past Imaging History comes in, representing another step forward in how healthcare providers track a patient’s past. PACS offer “enormous potential” in this area and could “provide important clinical information which patients themselves or their relatives may have failed to mention.” The information could also be automatically transferred to the patient’s electronic medical record.

The more information included in any given patient’s Past Imaging History, the authors explained, the more helpful it would be to health systems.

“We can recognize for instance the presence of prosthetic materials, distinguish between a biologic and a mechanical valve or identify the catheters of a pacemaker,” the authors wrote. “We can detect the presence of hemostatic clips used during a previous laparoscopic intervention that the patient has omitted to mention and which trocar-insertion scars were not promptly visible during the physical exam. We can also determine the date of an operation and the approximate length of a previous hospitalization.”

Tsioulpas and colleagues provided numerous other examples of how including such information in the PACS could make a significant impact. On the other hand, they also acknowledged that it won’t always be possible to gather such data. Perhaps previous examinations occurred at another facility, for instance, and that information was never properly catalogued or shared. Of course, some patients won’t have a history of imaging exams, meaning nothing would need to be included in this particular section.

“Ultimately, this may prevent asking for unnecessary exams, administering useless and expensive medications and performing avoidable procedures,” the authors concluded. “As a consequence, we can optimize available resources, reduce time to diagnosis and time to specific treatment initiation.”