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Virtually Indispensable

Growing demand and a shortage of radiologists have increased the need for teleradiology.

Virtual Indispensable

No doubt, teleradiology is here to stay. But it's not the teleradiology that started in the mid-1990s when high-speed communications networks sprung up across the country, making it possible for radiologists to read digital exams anywhere they had a workstation.

"Teleradiology grew rapidly in its first 10 years or so," says Shannon Werb, president and chief operating officer of vRad, a MEDNAX, Inc, company and a radiology practice and teleradiology company.

Early on, teleradiology was largely a solution to the need for interpretation of emergent after-hours studies. "Radiology practices would contract with companies like ours, and we would provide overnight preliminary interpretation such that the daytime practice didn't have to staff the overnight hours," Werb says.

These days, teleradiology is no longer a preliminary service only. Rather, it is an essential part of radiology reading services across the country and throughout the world. Teleradiology has moved from providing preliminary reads off hours to providing subspecialized final reports day and night.

"When I started with vRad in 2013, 75% of the volume was preliminary services," Werb says. "Today, we're running about 60% final and 40% preliminary." That shift is representative of the market maturing, which is enabling direct integration of a complete clinical history and results, along with payer enrollment, he says.

Subspecialists Needed Teleradiology also provides the specialty radiology coverage that is increasingly in demand but that health care systems can't afford to provide on their own. "Our field has changed, and the trend is for subspecialists to read subspecialty exams," says Philip A. Templeton, MD, FACR, CMO and founder of DocPanel.com, which provides on-demand specialty coverage. "It's very difficult today to be a general radiologist and also be good at neuroradiology, musculoskeletal radiology, abdominal imaging, pediatric imaging, etc."

With consolidation in health care and the need to keep costs down, radiology groups and hospitals can't afford to have subspecialists on staff 24/7 to read exams that require their skills—and it is impossible for small imaging centers to do so. So, they contract with companies like DocPanel that can provide subspecialists who can read specialty exams on demand. DocPanel doesn't require contracts. It will provide radiology services for one exam one time or for multiple exams over time. Its clients can build their own panel of specialists.

"It's like a fantasy football team or Match.com," Templeton says. "You can say, 'I like these two neuroradiologists and this pediatric radiologist' and use them for your reads."

DocPanel also provides radiology services for patients who want a second opinion. Templeton says that's an emerging category of requests that his firm is very focused on. "We frequently do get requests from patients and families who want a second opinion on imaging exams they've already had," he says.

Teleradiology also allows patients in nearly any part of the world to get expertise that was once available only to patients in urban areas, says Sham Sokka, Philips' head of radiology solutions. Teleradiology is allowing projects like SHINEFLY, a teleradiology application and services platform cocreated by Philips and Digital Health China, to meet the demands of China's rapidly expanding health care system. Launched in April, SHINEFLY is a cloud-based teleradiology service that will allow radiological images and associated patient information to be remotely viewed, analyzed, and reported on by clinical experts anywhere in China. The hope is that patients will be able to receive optimum treatment via their local hospital, wherever they are, Sokka says.

"There's enough money in China to purchase the necessary imaging equipment; they just don't have the physician infrastructure they need to make use of it throughout the country," he says. Philips is working with the Chinese government to identify pilot locations for this project and hopes to launch a few sites sometime early next year.

Consolidation and Radiologist Shortages Advances in technology may have been the primary driver of teleradiology in its early stages, but, once imaging became digital and broadband allowed technologists to easily upload the digital images they acquired to any PACS system in the world, teleradiology took off. It has also helped that EMRs and cloud sharing have made it easier for radiologists to retrieve prior studie