Emergency Neurosurgery Image Transfer System


Maximizing Neurosurgery Resources

Ontario’s 67 neurosurgeons work at 13 hospital sites but frequently share their expertise with more than 150 hospitals across the province.

ENITS is a centralized, secure, web-based PACS that makes remote consultations easier, faster and more accurate. Referring hospitals across the province ‘push’ head CT images to ENITS where they can be accessed by neurosurgeons anytime, anywhere.

How ENITS Works

ENITS is managed through CritiCall Ontario, a 24/7 emergency referral service that connects hospital-based physicians to resources such as acute care beds across the province.

Typically, an ER doctor at a non-neurosurgical hospital will contact CritiCall when a patient arrives with a suspected brain injury or illness. CritiCall links the doctor to a neurosurgeon who logs into ENITS to view diagnostic images that were taken at the patient’s home hospital.

CT images are a valuable addition to the consultation process because they provide neurosurgeons with more detailed information about the patient. From there, the local and referral physicians work together to determine how best to care for the patient and, ideally, avoid unnecessary patient transfers.

CritiCall uses sophisticated referral logic software to calculate the distance between the calling physician and potential sites in the province that can provide the necessary expertise. Referral pathways take into account the services available within the local LHIN cluster


  • ENITS went online in September 2008. Currently, 33 CT scanners in 27 hospitals across LHINS 1 through 4 are connected.
  • In 2005-6, more than 30,700 Ontarians had neurosurgery, and the demand is increasing.
  • In 2006-7, 72 patients were sent to the US for emergency neurosurgical care, at a cost of $6.2 million.
  • The average bill for patient transfer and treatment in the US is $180,000.
  • ENITS is funded by eHealth Ontario and has been informed by members of the Ontario Neurosurgical Action Team, chaired by Dr. J. Rutka.
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