Teleradiology: Images from Here to There...Now

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hiit040906Advances in telecommunications technology are having a huge impact on the field of medicine, and particularly in radiology. More bandwidth has allowed for the nearly instantaneous transmission of patient images and information from one location to another, no matter how many miles span between them. If an understaffed emergency department is in need of nighthawk coverage (or if day-time radiologists want to get some sleep at night), a virtual radiology provider can help. If rural or smaller communities need better access to healthcare, a virtual private network that links facilities to a sub-specialized group of radiologists may be the way to go. And even if surging imaging volumes are overburdening a radiology department during normal working hours or on weekends, a remote radiologist may be able to offer some assistance. Teleradiology is a staple — and growing — service that’s here to stay.

NORrad (Northern Radiology), a 15-hospital diagnostic imaging partnership in Timmins, Ontario, Canada, is extending radiological care to patients living in rural and remote communities throughout Northeastern Ontario. Thanks to the sophistication of PACS and digital image capture, NORrad hospitals rely on teleradiology to send their digitally acquired patient images to a centralized hub of radiologists in Timmins via a dedicated wide area network (WAN).

The practice of sending radiological images over the internet is relatively new, as broadband, high-speed internet connections have revolutionized the speed at which patient images are transmitted. Such advances have helped further the widespread utilization and acceptance of teleradiology.

Many teleradiology providers allow healthcare facilities to outsource the readings of their medical images dependent on their needs. For example, these vendors serve small and medium sized hospitals and offer day, night and weekend coverage as well as vacation coverage. Initially used as a way to obtain preliminary reports, vendors say more sites are requesting final interpretations.  NORrad is similar to this in many ways, but has the distinct advantage of an implemented MPI (master patient identifier), says Mike Gasparotto, PACS administrator for NORrad.

Still, regardless of how teleradiolgy is practiced, the benefits are the same all around: timely access to radiology care via remote imaging interpretations.

NORrad’s workflow in a film-based environment was impeded until it installed Agfa Healthcare’s Impax PACS. “Prior to PACS, if a critically ill patient in Hearst, Ontario, needed his or her films looked at, there was a good chance the patient and films would be transferred to Timmins [about a 3-hour drive],” says Gasparotto. With PACS, radiology studies are acquired in filmless departments and electronically transmitted over large bandwidth to awaiting radiologists in Timmins. Images are instantly read and reports are returned back to the hospital within minutes.

In addition to improved report turnaround times, teleradiology has expanded access to subspecialized, radiological care to the patient community. Rural physicians who may lack access to or experience with modalities such as CT, MRI and specialties such as orthopedics, can rely on NORrad. Remote consultation also is possible. “A physician at one of the small hospitals can contact an orthopedic surgeon in Timmins to get a consultation in a matter of minutes,” says Gasparotto.

Outsourcing imaging interpretation

“Teleradiology today has made huge strides from just five years ago,” says Eduard Michel, MD, medical director, Virtual Radiologic Company (VRC), a teleradiology provider based in Minneapolis, Minn. “At that time people were doing teleradiology mainly at night. Today, teleradiology has been accepted into the mainstream practice of radiology.”

A number of factors have contributed to the growing utilization of remote radiology reading services. Consider the nature of the field today: research shows that radiology imaging services amount to 15 percent of a hospital’s total system revenue, imaging volumes have tripled and many practices provide 24-hour coverage. In addition, current staffing shortages plague many healthcare institutions.

As telecommunications technology and equipment has improved, and medical imaging continues to be a revenue generator for healthcare facilities, teleradiology offers a way to mitigate radiology staffing shortages and handle increasing image volumes. Hospitals, clinics and imaging facilities nationwide