Remote Reading: Teleradiology Makes for Smooth Operators

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 When it comes down to it, teleradiology is an enabler. The possibilities of remote reading can make a small enterprise with one radiologist seem like it has a much larger staff, nearly around the clock. This makes for faster, better care for patients and referring physicians, as well as a competitive business advantage.

Technology has made remote image reading easy. A facility acquires the images and sends them to PACS. If a remote read is needed, either the images are transmitted via a secure line or the radiologist on the other end accesses it via the host PACS. Depending on urgency, the reports can be back in 10 to 30 minutes, an hour, a couple hours, or a single day. Most teleradiology companies also make their radiologists available by phone for questions, and will call regarding any abnormalities found. The technology and service are not the issue. The question is: how can this service improve or maintain your workflow regardless of the time of day?

No interruptions

Using remote reading services has become a real world radiology necessity, basically. Only now will do when it comes to acquiring and reading images. It’s getting to be that you can’t operate without it. The reasons are not rocket science. As Laura A. Hotchkiss, MD, of Spokane Radiology Consultants, of Spokane, Wash., points out, you need teleradiology if you want to maintain staffing or do any physician recruiting, or just plain let a radiologist get a night’s sleep or take a vacation. “I don’t really think you can recruit without a nighthawk service anymore because radiology has become a 24-hour service and people expect instant imaging and instant answers,” she says.

Spokane Radiology Consultants reads for two hospitals in Spokane, Deaconess Medical Center and Valley Hospital and Medical Center. So, they have plenty of images coming their way. They have contracted with NightHawk Radiology Services for fill-in or off-hour coverage — for as many as 30 studies a day.

Sometimes NightHawk is called in so they can do something as simple as have staff meetings. “The hospital doesn’t stop. That’s the only way to have everybody at the meeting,” she says. In these cases, the full staff meeting is planned for end-of-day, and Nighthawk takes it from there.

There’s never a time that a radiologist isn’t available during Spokane’s hours of operation. The NightHawk service is dynamic enough so that if one radiologist is busy, the studies are forwarded to the next available radiologist with hospital privileges, Hotchkiss says.

In the case of Premiere Scan, an independent, privately-owned, imaging center providing MRI and CT services to physicians in San Jose, Calif., Virtual Radiologic Consultants provides not only back-up for general radiology studies but also multiple specialties such as virtual colonoscopy as well as TOS (thoracic outlet syndrome).

Through remote reading, they “can offer a community of physicians and patients different specialty types of scans and have the appropriate radiologist doing the reading. Virtual Radiologic has the appropriate type of expertise to meet the protocols to effectively give readings,” says Shiela Galupo, Premiere Scan’s marketing manager.

Though in Premiere Scan’s case remote reads are done on both general and subspecialty images, the point is the same: hiring off-site radiologists to remotely read keeps their workflow running without a hitch.

“We have the ability to use VRC if our primary medical director is unable to do a stat read during the day,” says Galupo. She adds that “occasionally we get stat reads in the evening hours because we are open so late and we need to have the ability to either do an emergent wet read with a turnaround time of 10 minutes or a stat read within 30 minutes.” This gives them fast turnaround even after hours.

Some facilities, like 407-bed Baptist Hospital East that serves Louisville, Ky., look to keep the radiology staff, particularly the technologists, cranking on the many CT studies they do each day rather than bogging them down with the 3D reconstructions that many of their referring physicians request. Hiring 3DR Inc., a teleradiology provider in Louisville that specializes in 3D reconstructions, has been a big time and cost savings option.

“It’s very time-consuming to do this in-house, not to mention the cost of the workstation with the software to do the 3D, and then the time for a technologist to sit at the workstation and do it,” says Pam Colburn, director, Department of Radiology.