Remote reading is here to stay: How radiology can prepare for a virtual future

Remote working has become the norm amid the current pandemic and radiology is no exception. Many practices have already adapted to the new climate, while others continue to ramp up operations. But organizations should prepare for at-home reading to extend well into the future.

That was the message delivered Wednesday by a group of imaging informatics experts during the Society for Imaging Informatics in Medicine’s virtual meeting.

Matthew Hayes, a PACS manager at Radiology Partners, one of the largest private imaging providers in the U.S., says he’s virtually onboarding more and more radiologists from out of state. Couple that with rads’ enhanced productivity and the benefit of instant access to subspecialty experts, and Hayes believes there’s going to be an “uptick” following this initial wave of remote installations.

“I’m a firm believer there’s not going to be much of a desire to go back,” Hayes said during the presentation. “[Remote reading] could be a new normal in a specific paradigm shift for all of us and we’re going to have to adapt.” 

He offered a few suggestions for institutions looking to get started or augment their setups.

Formulating a plan is key. Avoid the impulse to make a “knee jerk” decision to appease a physician or operations director that comes “banging on your door,” he cautioned. Take an inventory of assets and determine who needs what. For example, does a neuroradiologist need four medical-grade diagnostic monitors? And does your hospital have those on hand or the funding required to purchase them?

Aside from the IT infrastructure challenges required for at-home PACS, organizations need to consider who is going to troubleshoot problems. What if a head CT for a stroke protocol is taking 15 minutes to load? The radiologist needs to talk with someone quickly via a helpdesk. Even simple fixes such as HDMI connections can be solved ahead of time with simple, easy-to-read PDF instructions, he said.

There are a number of other challenges to think of when constructing remote imaging workstations, according to Mike Silosky, MS, assistant professor of Radiological Sciences at the University of Colorado Anschutz Medical Campus.

Silosky said his facility was initially trying to keep remote reading to a minimum. They moved radiologists around the building and campus to abide by social distancing requirements. And for a while, communication was an issue, he said.

For at-home workstations, however, they’ve started with more experienced readers. Non-medical monitors are tested and calibrated to DICOM standards and Anschutz helps doctors achieve ideal at-home light conditions for interpreting images.

While imaging experts seem to enjoy working from home, Silosky has already encountered drawbacks. Radiologists don’t just read images, he said, they protocol exams, communicate with technologists, and work with on-site review committees, among other duties.

These problems, along with the financials required for at-home PACS, remain barriers to a remote-working revolution in radiology.