Remote Reading Offers a Final Solution However It's Not Needed

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As remote reading gains in popularity and adoption increases, what began as a way to provide nighttime coverage to busy hospitals and facilities, extra help while radiologists vacationed or as a temporary staffing solution, has now evolved to include weekend coverage, daytime interpretations, preliminary and final as well as subspecialty interpretations for small and large healthcare organizations.

Final Reads

Using remote reading for final interpretations is a way of streamlining workflow, even on individual, case-by-case situations. Facilities can choose remote reading for final reads when necessary, for a more cost-effective solution.

Joseph Tienstra, MD, president of Florida Radiology Consultants (FRC) in Fort Myers, Fla., knows first-hand the economical benefit of using a teleradiology vendor for final reads. The main advantage to having a teleradiology service do preliminary reads is cost, he says. Prelims are about $50 compared to the cost of final reads, which is about $70 per read.

However, preliminary reads leave a lot of repeat work for a radiologist to do the next day. “We decided it was more cost-effective in a busy practice such as ours to pay the extra money for final reads, which leaves the radiologists able to start the next day’s work right away, instead of wasting time over reading in the morning,” he says.

In the last five years, Tienstra says the group has seen CT use in the ER grow significantly. “We have seen an explosion in CT [studies] in our group, and it quickly became apparent that we were staying up all night looking at images on the eRAD PACS,” he says. The download time took too long from home computers to combat the sheer volume of studies to be read.

Also, if a radiologist was up all night reading CT scans, he or she had to be taken off the rotation for the next day. “We were looking at taking up at least a 1.3 FTE [full time equivalent] requirement of staffing as well as determining who was going to be up all night every other week,” Tienstra adds.

FRC looked to Virtual Radiologic Corporation (VRC) for preliminary night reads and then for final reads on Friday and Saturday nights to cover staff shortages. Tienstra says they quickly realized the cost and time savings possible by having VRC do all final interpretations. VRC has been doing final reads at night for the last nine months.

The move has allowed for more productivity during the most demanding part of the day.  “It is totally a different situation now—a start fresh from the get-go,” Tienstra says. “When the radiologists show up at the hospital, they can immediately start to take care of that day’s work in the morning.”

Late night

In contrast, McCready Health Services Foundation in Crisfield, Md., uses remote reading to provide night coverage for the sole radiologist on staff at this small community hospital.

“If during the night, a study is not a STAT read, we save it for our radiologist to do the next day to keep costs down,” says Imaging Department Director Lesli Beckett, RT(R), ARRT. Since 2004, the foundation has been using Templeton Reading for final STAT reads at night.

Beckett says the radiologist onsite was retiring and McCready needed full-time coverage while a replacement was found. Now, Templeton provides final-read remote coverage each weekday after 2 p.m. until 8 a.m., 24-hour coverage on weekends and holidays and week-long virtual locums coverage when the onsite radiologist is scheduled away, or for any unexpected fill-in needs. For McCready, the benefit of using remote reading for final reads does not translate into cost savings, except during the week-long virtual locums coverage.

The benefits of final remote-reads go beyond cost savings or the ability to have quick report turn-around. They go a long way toward distinguishing radiology services within a community. Amir Glogaus, president and CEO of Advanced Diagnostic Group Imaging Centers in Tampa, Fla., is utilizing Franklin & Seidelmann Subspecialty Radiology for final remote-reads to “become the leading provider of MRI and CT as well as all other imaging services throughout Florida” by offering final interpretations to his referring physicians in any area of expertise.

“One of the key things from our perspective is to offer our referring physician a radiologist of his or her choice,” he says. “We have no internal interest in who reads for whom and why. For the most part, our referring physicians would rather have a radiologist who can offer a final interpretation