When trauma patients are transferred from outside hospitals, the receiving clinicians often consult their local radiologists for definitive interpretations of outside examinations (IOE). Such requests introduce a host of logistical, medicolegal, and financial concerns related to quality control and resource utilization. We surveyed 701 members of the American Society of Emergency Radiology to elucidate these concerns. We found that the majority of emergency departments still rely on compact disks for conveyance of outside images; hard film and network transfers were minor mechanisms for most respondents. Sixty-nine percent of the respondents indicated that radiologist reports accompany fewer than 25% of all transferred imaging studies; of the reports that do arrive, most are unverified preliminary reads. There is considerable variability in billing practices and reimbursement patterns for radiologic second opinions; 68% of the respondents do not know how often their IOEs are reimbursed. Suboptimal communication between community hospitals and referral centers may result in duplicated efforts and inconsistent quality of medical imaging studies. Further investigation into the role of radiology trainees in the handling of outside studies is also highly recommended.
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