What is Teleradiology?

Telemedicine is the application of numerous technologies for the transfer of clinical information. The introduction of the internet has enabled telemedicine to expand its reach across every medical specialty – its use in radiology is termed “teleradiology.”

Radiology encompasses the diverse techniques used by medical professionals to capture images of the internal body (eg. x-rays, MRIs, ultrasounds), to aid in the process of diagnosis or treatment.

Teleradiology is the ability to obtain these medical images in one location and their transmission over a distance so that they can be viewed and interpreted for diagnostic or consultative purposes by a radiologist.

This recent practice is becoming widely implemented by hospitals, urgent care clinics and specialist imaging companies. The reason for its increased implementation is because it addresses the lack of adequate staff to provide radiological coverage and the lack of expertise in this speciality.

The process of teleradiology is based on an essential triad; an image sending station, a transmission network, and a receiving image station that must have a high-quality display screen that has been cleared for clinical purposes. In fact, there are now specialized computer programs that are dedicated to sending radiological images with the same ease associated with sending an email with image attachments.

Teleradiology improves patient care by allowing radiologists to provide their expertise without being present with the patient. This is particularly important when radiologist specialists (e.g. MRI radiologists, pediatric radiologists, neuro-radiologists) are needed, since these professionals are generally only located in large well-established areas working during day time hours.

In contrast, smaller hospitals in rural areas may employ only one radiologist or none at all. In some cases where these radiologists are not adequately trained, the interpretation of some radiological images may require input from a specialist radiologist.

Teleradiology can be a means through which medical professionals can collaborate when they are not otherwise reachable to each other (e.g. they are in remote locations). This can be an effective input for diagnosis and symptom control as it often helps with obtaining a second professional opinion.

By using the services of outsourcing companies or radiology groups to provide and maintain the required radiology coverage, smaller hospitals are able to make better use of their own on-site professionals and allows them to maintain their normal working hours.

This can also be economical for the hospital as the outsourced institution will only require payment per radiological exam. The provision of these specialist services to manage inpatients at small hospitals without specialists on site has been shown to be an effective way of providing high quality care that would otherwise be unavailable.

Unfortunately, recruiting external teleradiology providers for off-hours coverage may carry a risk to the reputation and professional standing of resident radiologists. Arguably, these professionals may feel or become a less integral member of their institution than if they were to provide all of the professional radiology coverage. Their roles may even be threatened if their superiors perceive what they do as radiologists to be a service that can be purchased elsewhere.

With all the benefits it offers, there is still a limit to what radiologists can achieve with the use of teleradiology. For example, the transfer of images does not give the radiologist receiving the images the opportunity to follow up with other patient procedures. Therefore, they must convey the appropriate information to the on-site doctors. This is not always effective and can often lead to miscommunication and confusion.

Furthermore, teleradiology is entirely dependent on technology so should there be no access to the internet (e.g. if the hospital’s internet is down for service), teleradiology is no longer an option and patients will remain undiagnosed or even untreated.

References:

• http://www.teleradiologygroup.com/
• http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2747412/
• http://pubs.rsna.org/doi/full/10.1148/radiol.2433070350
• http://pubs.rsna.org/doi/full/10.1148/radiol.2442070676