Introduction would start on heparin prior to a lung scan performed the next day.
Teleradiology is the electronic transmission of radiographic images from
Why has
one geographical location to another for the purposes of interpretation and This approach has been largely replaced by immediate multi-slice CT (MSCT)
consultation.
teleradiology
or CT pulmonary angiography (CTPA), regardless of the time of day that the
patient presents. The requirement for 24/7 radiology, or at least something very
Sounds simple, doesn’t it when defined in that way? Why then has the introduction
caused
similar, is becoming compelling; not easy even for training departments let alone
of teleradiology caused so much debate and, indeed, so much unhappiness smaller district general hospitals to deliver. How much easier then if the images
amongst the professions? Individuals and professional bodies cite issues of quality,
so much
could be read by a radiologist who was already awake, a night service either
of lack of consent, of loss of continuity of care, of legal jurisdiction, amongst others locally provided, or located in a part of the world where it was 10am rather than
to oppose the growth of teleradiology as a method of delivering imaging services.
unhappiness?
midnight?
It is important, however, to separate the technology from potential applications.
If volume of work is a problem, why not use teleradiology to transmit images to
Why is teleradiology so important? where there are teams of radiologists waiting to provide a reporting or reading
The world of medicine has been irrevocably changed by the advances in medical service?
imaging. Patients presenting to primary or secondary care are now much more
likely to undergo imaging as part of the diagnostic work up. In Japan, for example, What’s in it for the patient?
the number of imaging investigations approaches three per head of population, The potential benefits to the patient are significant:
per year. In the United Kingdom (UK) the number remains less than one but the Access to local provision of image acquisition and, where necessary, immediate
growth of imaging procedures continues at a rate of three per cent per year. For access to expert opinion even if this is at many miles distant;
some specialist investigations such as computed tomography (CT) the growth rate Speed and turnaround time of reports are said to be enhanced by the judicious
far exceeds this, with some departments reporting an annual growth of more than use of teleradiology service providers;
25 per cent. Immediate availability of appropriate emergency investigations even if the local
hospital does not have an on-call radiologist; and,
The ability to receive and view images acquired at a geographically different The radiologist reporting the images is not the same one who was awake at
location has the potential to improve markedly the provision of imaging services. 3am the previous morning reporting someone else’s emergency CT.
Remote communities where the volume of work would not support the services of
a whole time radiologist, now have the potential to benefit from the same level What’s in it for the hospital and the National Health
of service as a major centre, at least for simple imaging investigations. Weekly
Service?
or fortnightly visits by a reporting radiologist with the inherent delays that this Teleradiology has the potential to address lack of local expertise, shortfalls of
involves, can now be replaced by immediate transmission of images and rapid turn radiology provision, peaks and troughs of demand, backlogs of work, out-of-
round of the report. hours workload and availability of expert opinion. It opens up the world as a skills
resource for the NHS to exploit.
Where the investigation or the condition is complex, images from any institution
can be transferred immediately to a specialist centre, or to a recognised specialist What’s in it for the radiologist?
for a primary report or for a second opinion. Case conferences between specialist Teleradiology offers the radiologist the opportunity to review images from home
radiologists, specialist clinicians and local doctors are possible on line. Decisions rather than attending the hospital out of hours. Workload could be managed more
can be taken about whether the patient is treated locally, or transported to the effectively, and the potential for shared provision across the world could allow
centre for expert care. defined working patterns and achieve improvements in work life balance, if it
were possible to co-ordinate radiology services across different time zones.
Thirty years ago, a patient presenting with right iliac fossa pain would be seen
by a surgeon and, usually, an operation would be performed. The surgery would What’s in it for the radiographer?
function as both a diagnostic and a therapeutic tool. At that time, too, a patient Teleradiology makes new demands on radiographers and places new
with pleuritic chest pain and shortness of breath would have a chest x-ray and responsibilities on them. Working in departments without the presence of a
2009
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IMAGING & ONCOLOGY
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