Subspecialty Reading Services: Quality Reads Peace of Mind 24/7

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  ProScan radiologists and fellows discuss cases in their Cincinnati, Ohio, “West Wing” reading room.

With the emergence of advanced imaging capabilities for MRI, multidetector CT, SPECT/CT and PET/CT, the demand for subspecialty expertise for radiology reading has skyrocketed over the last few years. In fact, the use of radiology has tripled since 2003. Clinicians are now looking for more precise, high-quality, in-depth reports for better diagnoses within 24 hours.

Teleradiology service providers are shining a light at the end of the tunnel. In addition to providing “nighthawk” hours, or after-hours support, many vendors have expanded their service offerings to include fellowship-trained, board-certified radiologists in areas such as neuroradiology, CT virtual colonoscopy and orthopedics who can deliver detailed reports in a matter of minutes, rather than days or even weeks, in a multitude of subspecialties. More radiology departments and groups are turning to reading services providers for subspecialty expertise than ever before.

Demand for expertise 24/7

Radiologic Associates is a 20-radiologist group comprised of Hudson Valley Imaging, Orange Regional Medical Center and St. Luke’s Cornwall Hospital, which serves Orange County and the Hudson Valley area in New York. Two years ago, the company—which had contracted with the full-service teleradiology provider Imaging On Call (IOC) for after-hours support—determined it needed more than routine “nighthawk” coverage.

The group needed to expand their coverage to keep up with the increased demand from referring clinicians for expertise in neuroradiology cases, according to Joseph F. Yacovone, MD, president of the Middletown, N.Y.-based practice. The practice performs approximately 350,000 to 400,000 imaging procedures per year.

Offering after-hour support for that expertise, however, raised concerns over the level of quality of the reads, says Yacovone. “The bar has been raised quite a bit as to the quality of readings during off-time hours,” he says. “We have to be as accurate as possible with every single reading whether it is done at 2 p.m., 6 p.m. or 3 a.m.—we cannot afford to make a mistake.”

Yacovone says that the difficulty is that “when people are on call, obviously not every one is trained in a subspecialty area such as neuroradiology, body CT, musculoskeletal imaging or interventional imaging.” Because of that, when the practice does have a particularly difficult neuroradiology case, they have someone from IOC with  neuroradiology expertise to rely on.

“The main value [to that] is peace of mind for the people in my practice,” he says. “We know that we won’t be put on the spot in an uncomfortable situation, having to make a serious decision when we are not subspecialty trained in that area. If you have a body CT [radiologist] on call and he or she is put in the difficult position of making a decision on whether a child goes to the OR for a head or neck or neuropathology case, it is nice to know that that there is a subspecialty neuroradiologist available who can provide report within 30 minutes, depending on the study. It is that peace of mind that you can provide quality services around the clock.”

Staying ahead of the competition

The reason PremiereScan, a privately-owned single-center imaging facility in San Jose, Calif., chose teleradiology provider Virtual Radiologic for subspecialty expertise in virtual colonoscopy 24/7 was to gain a competitive position in the market. 

“We are a physician referral-based company and we noticed other imaging centers were offering virtual colonoscopy,” said Sheila Galuppo, sales and marketing director at PremiereScan. “It has the support of [clinical] studies, the medical community and the technology has improved so much over the next few years that virtual colonoscopy is going to become more mainstream, which is why we wanted to offer our community an expert on the subject.”

Galuppo says that the Minneapolis-based teleradiology provider gives the company exclusive access to one subspecialty, fellowship-trained radiologist for virtual colonoscopy—which sets them apart from local imaging centers offering the service.

“Offering exclusive subspecialty expertise makes us very marketable because we are providing a service that may not be provided by a center down the street,” Galuppo says.

The demand for quality care

Black Hills Surgery Center in Rapid City, S.D., is a 26-bed specialty hospital with seven operating rooms that offers