Arjun Kalyanpur, Founder, Teleradiology Solutions
The Teleradiology market is expected to grow steadily in the coming years. Radiologist shortage is the main factor driving the growth of the market. At the same time the utilization of radiology within clinical medicine is increasing as new technologies and applications are developed and lifestyle diseases such as cardio vascular disease and stroke increase in prevalence. Consequently the amount of image data generated by imaging departments is rising exponentially increasing the workload of the available radiologists. The immediate solution involves the use of technology to distribute the workload among the radiologists that are available in the workforce. Teleradiology workflow platforms incorporate efficiency and productivity tools that augment radiologist productivity, allowing for shortening of report turnaround times.
The Indian Scenario
In India the investment environment in healthcare has resulted in profusion in growth of imaging centres and hospitals. The main users of Teleradiology are diagnostic imaging centers in small towns in the periphery where radiologist availability on site is limited. The radiologist may only visit the center for a few hours a day. Emergency scans and X-rays performed at other times would potentially have their reporting delayed. Today, with the implementation of Teleradiology, immediate reporting by a radiologist in another location is made possible. Hence, the acceptance of teleradiology is high as it results in greater patient satisfaction and improved patient care due to increased access to high quality radiologic diagnosis, including subspecialist radiology reporting.
"Today, with the implementation of Teleradiology, immediate reporting by a radiologist in another location is made possible"
Highlighting the Benefits
Hospitals and medical institutes that fail to adopt Teleradiology face the risk of potential coverage breakdown during emergency after hour’s coverage. In a manpower shortage environment it is the night shift that is affected the most. It is also expensive for a hospital system to have a radiologist in-house at each of its individual hospitals overnight. It makes better financial sense to deploy a single radiologist reporting for all the sites at night via Teleradiol ogy, or alternatively to outsource the reporting to an established Teleradiology provider of demonstrated quality. Further as radiology has become more specialized, it is beneficial for a small medical institution to have access to a larger pool or group of radiologists with subspecialty expertise to enhance reporting quality for complex scans.
Best Practices around Teleradiology
The best practices in the teleradiology environment are as follows:
a) Ultra-short turnaround: Teleradiology facilitates immediate reporting and contributes greatly to emergency setting, particularly in conditions such as a stroke.
b) High reporting quality: Using teleradiology, scan images can be transmitted to the radiologist with the highest level of expertise in the subspecialty allowing highest possible reporting standards to be met.
c) Communication: In the teleradiology environment, the level of communication between referring physician and radiologist is kept at a level commensurate with that of the in-hospital radiologist.
d) Security and patient confidentiality: Teleradiology practices need to be compliant with HIPAA or equivalent security standards.
e) Robust Quality Assurance Program: Having high level analytic process for error detection, review and feedback is critical.
f) Integration – Through interfaces such as HL-7, the teleradiology workflow platform can integrate with and seamlessly exchange information with other information systems such as HIS, EMR etc, which benefits patient care and improves disease outcomes.
Addressing the Loop Holes
There are loopholes in the Teleradiology market that need to be addressed. These include: IT infrastructure challenges, medico legal requirements, and business considerations such as equipment and system costs. The technology industry can also help address these gaps which pose a threat to the growth in the adoption of Teleradiology.
Remote areas tend to have challenges of connectivity. It is pertinent for telecom providers to continuously innovate to bring high level connectivity to remote peripheral locations with reliable uptimes and low cost. Imaging companies in the industry can focus on developing low cost imaging equipment that can be easily deployed and installed in remote locations, with reliable after-sales support and service.
From a regulatory perspective, Teleradiology is governed by strict standards of security, such as HIPAA in the United States (Health Insurance Portability and Accountability Act) which requires a high level of compliance. Using high-level encryption ensures a high degree patient confidentiality. Further, radiologists practicing Teleradiology need to demonstrate appropriate registration, insurance and licensure. Measures such as accreditation by a standard organization such as the US Joint Commission also add value in the teleradiology scenario.
Current and Future Scenario
In keeping with Moore’s law, the cost of telecommunication as well as the storage and processing capacity of the computer/server hardware needed, are constantly evolving and improving. The internet cloud has also facilitated a drop in costs. Therefore, for a hospital or radiologist group, there is no longer a reason to purchase additional expensive storage/archival infrastructure, making the deployment of teleradiology inexpensive and practical.
The future of teleradiology is bright, as it is today an essential part of healthcare delivery. There is a strong clinical need based on imbalance between imaging utilization and radiologist availability. Telecommunication and IT innovation are ongoing technical drivers that facilitate its growth. Above all, there is a strong value addition in terms of improved quality of patient care that makes the most profound argument for the growth of teleradiology in the future.
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