Protecting trauma patients from duplicated computed tomography scans: the relevance of integrated care systems

• Two tertiary trauma centers are examined, one within a integrated healthcare system and the other within a non-integrated healthcare system.
• We observed the difference in duplication of CT scan acquisition in transferred trauma patients between the two centers.
• The integrated system has fewer patients that received duplicated CT scans than the non-integrated system.
• The reasons, as given by the receiving trauma surgeon, for these differences were collected in a prospective manner.

BackgroundDuplicated computed tomography (CT) scans in transferred trauma patients have been described in university-based trauma systems. This study compares CT utilization between a university-based nonintegrated system (NIS) and a vertically integrated regional healthcare system (IS).MethodsTrauma patients transferred to 2 Level I trauma centers were prospectively identified at the time of transfer. Imaging obtained before and subsequent to transfer and the reason for CT imaging at the Level I center were captured by real-time reporting.ResultsFour hundred eighty-one patients were reviewed (207 at NIS and 274 at IS). Ninety-nine patients (48%) at NIS and 45 (16%) at IS underwent duplicate scanning of at least one body region. Inadequate scan quality and incomplete imaging were the most common reason category reported at NIS (54%) and IS (78%).ConclusionsFewer patients received duplicated scans within the vertically IS as compared with a traditional university-based referral system. Our findings suggest that the adoption of features of a vertically IS, particularly improved transferability of radiographic studies, may improve patient care in other system types.