news has previously written about the fact that more and more MRI and CT examinations are being taken of Norwegians. In many cases, the examinations can be completely unnecessary, and contribute to pushing seriously ill patients to the back of the healthcare queues. One of the reasons why the healthcare system takes many MRI and CT images is that many patients are imaged twice – without really needing to. – It has long been a well-known problem, says department director for research and diagnostics in Helse Sør-East, Lars Eikvar. Lars Eikvar, department director for research and diagnostics in Health South-East. Photo: Katarina Theis-Haugan Not talking together A typical example is that a patient receives an MRI examination at a private X-ray institute, before a new MRI examination is taken when the patient is sent to the hospital. The main reason why this happens is that the computer systems at the various hospitals in Norway and at the private clinics do not “talk to each other”. In order to get hold of the original MR image, a lot of extra work is required, according to professionals news has spoken to. – The radiological examinations are carried out in private, in other health facilities and with private operators. It’s like finding your way through a jungle, says Pieter Oord, who is section chief in traumatology at Stavanger University Hospital. Pieter Oord, section chief in traumatology at Stavanger University Hospital. Photo: Rolv Christian Topdahl / news This leads to doctors ordering a new examination of the patient instead. – In the event of acute incidents, it also happens that we do not have the time or resources to retrieve old images, says Nina Rolland Krogh, who is head of the diagnostic imaging department at Akershus University Hospital (Ahus). No one knows the extent In a report from 2019, the Directorate of Health writes that a “not insignificant” amount of unnecessary double examinations are carried out at Norwegian hospitals. The only problem is that nobody knows how many. – For our part, we would like to have more concrete information about this issue, says Ahus department director Rolland Krogh. However, there are not only technical reasons why surveys are redone. According to department director Lars Eikvar at Health South-East, quality also plays a role. An MRI examination can take anywhere from 15 minutes to 60 minutes. Photo: Ingunn Aabel / NTNU – The reasons may be that the examinations are carried out differently, that not as many images have been taken of the relevant organs and structures, or that the quality of the images does not make it possible to answer new issues, he says. Working on a solution According to Eikvar, the problem with double examinations is greatest in Eastern Norway. The reason is many hospitals, different ICT systems and a high proportion of investigations carried out by private actors. In Norway, 67 per cent of outpatient MRI examinations are carried out at private X-ray institutes. In the hospital areas of Eastern Norway, for example in Østfold (77 per cent) and Vestfold (84 per cent), the proportion is higher. Health South-East is now working to reduce the number of duplicate examinations. – A common regional ICT solution for diagnostic imaging in the hospitals is being established. Work is being done on a new regional, electronic interaction solution for the exchange of images, says Eikvar. He can draw inspiration from Western Norway: Since 2014, Helse Vest has worked to coordinate the various systems at the hospitals in Western Norway. Among other things, they have standardized the way in which radiological examinations are carried out, so that the examinations are carried out in the same way whether it is in a hospital or in private clinics in the region. – Since we have already been working on this for a long time, double examinations are not a big problem for us in the west, says assistant specialist director at Helse West, Panchakulasingam Kandiah. Panchakulasingam Kandiah, assistant professional director at Helse Vest. Photo: Kjetil Alsvik But the hospitals in Helse Vest still do not have direct access to the image archives at the private clinics. – It is desirable, but as of today difficult to achieve, says Kandiah. Pieter Oord believes that should be in place. – All documentation belonging to the patient, whether it is photos or journal notes, must be available at all times to those treating the patient. This should have been collected on one common server, he says.
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