Providers' Access of Imaging Versus Only Reports: A System Log File Analysis.

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.