Teleradiology has evolved rapidly over the past five years and become a robust and versatile service. Today in the developed world a large and growing number of hospitals and diagnostic centres utilize teleradiology to meet their radiology reporting needs.
The key drivers that make teleradiology a valuable technology and service for the health care industry continue to grow. On a macroeconomic level, health care costs continue to rise. It is estimated that the US, which currently spends 15 per cent of its GDP on healthcare, will spend 25 per cent of the same by 2030, a staggering figure! Globally the population continues to age as life expectancy increases. However, the later years tend to be filled with medical events that contribute significantly to spiralling health care costs. The only viable strategy that can tackle such a paradigm is a dual emphasis on screening and early detection of disease, both of which have the potential to significantly bring down subsequent costs of treatment. This, coupled with innovative uses of technology, particularly information technology, is where the future lies.
On a more practical and day-to-day level, though, the issues that continue to drive teleradiology are regional shortages of radiologists, (currently estimated, in the US to be as high as 20 per cent), which can be balanced by cross border transfer of diagnostics. Simultaneously, with the development of faster imaging technologies (64 slice CT, high field strength MRI) there is a constant, across the board increase in the number of scans being performed worldwide that need to be interpreted. Add to this an overall increase in the utilization of emergency and night shift imaging and a potent combination is generated.
The bulk of the work done via teleradiology still consists of emergency or after-hours coverage. This has the advantage of allowing the local radiology group to work during their most productive time, i.e. daytime and then get a good night's rest while signing out to a 'nighthawk' service. When coupled with a global operation where the reporting radiologists are located on the other side of the globe, diametrically opposite the site of origin of the images, this has the added benefit of significantly increasing both quality and radiologist productivity. Use of high bandwidth pipes allows for images to be sent across the globe in a few minutes and for a report to be generated in under 30 minutes.
However, teleradiology in the recent past has increased its scope and become more 'mainstream' and no longer just night shift. Today the applications of teleradiology include subspecialty reporting of outpatient daytime studies which can then be turned around in 12 hours or less, so that the report is available by the time of the patient's next clinic visit.An added benefit of this is that the radiologist best qualified to report the examination can be specifically routed the study, eg, a radiologist specializing in diseases of the brain and spine can be sent specifically those studies for reporting. Valuable productivity and quality benefits ensue.
Applications
Another successful application of teleradiology has been the development of remote 3D labs, which perform 3D post processing from a centralized location, serving a large global community of hospitals and imaging centres. With the increased utilization of multi slice CT scanners (these acquire images at sub millimeter resolution but simultaneously generate massive volumes of data which then need to be post processed to obtain the optimal information) in cardiac and colon screening programmes, the remote 3D lab is seen to be of great value. The workstations that are required for this purpose are high-end and expensive and the technologists to perform the labour intensive operations are in short supply. An outsourced model is therefore a significant value added.
As awareness about its many benefits spreads, the market for teleradiology continues to grow. Countries like the UK have recently opened their doors to medical outsourcing, in an effort to combat the expenses and inefficiencies of the NHS delivery system. Similarly other countries in Europe and other parts of the world are also exploring teleradiology as an option for bringing down their health care costs and plugging troublesome staffing shortages.
Further, as bandwidth penetration continues to improve and broadband costs drop, teleradiology will become a viable option for developing countries such as ours, to bring high quality diagnostics to remote areas. Our own organization's goal is to provide teleradiology services to hospitals in small and medium sized towns throughout India. We feel that we can provide high quality diagnostic services of an international standard to these locations and facilitate timely treatment to sick patients. Without a correct diagnosis, the correct treatment cannot be given, and therefore we see this service as being of significant value in the Indian health care delivery system.
In future, we can expect that teleradiology will slowly but surely become an integral part of the global health care delivery system. A powerful workflow distribution tool, it carries significant benefits for both patients and physicians, and for people in both developed and underdeveloped countries alike.
(The author is chief radiologist and CEO, Teleradiology Solutions)