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patients – continuously dividing their time between medical procedures, reporting, multi-disciplinary meetings, and being on call – teleradiology has proven to become a valuable asset to the medical world. Teleradiology is the transmission of images and associated data between locations for the purpose of primary interpretation or consultation and clinical review. It also encompasses the process of remote viewing of images via a web browser, and such processes involve the sharing of patient identifiable information, within and among organisations and potentially across international boundaries. Initially introduced to healthcare


as a solution due to a significant shortage of radiologists on location, today’s teleradiology technology assists local hospitals and radiology practices in meeting the demand for larger access but with lowered costs, as well as increased collaboration and sharing of knowledge between professionals, enhancing medical care in the process. There are two main types of teleradiology: the stored & forward method, and the live method.

THE STORED AND FORWARD METHOD When using a Patient Archiving and Communications System (PACS) for digital studies, the stored and forward method allows remote radiologists to view studies, report and work through a task list as part of their daily function in a pull model. That is, the radiologist selects the study, pulls it from the PACS engine and

ith radiologists frequently working extended hours to meet the needs of their

 Today’s teleradiology technology assists local hospitals and radiology practices in meeting the demand for larger access but with lowered costs

when it eventually arrives on the target PACS workstation, their report can be complied and filed. This method is especially useful

when the reporting radiologist is not located in the radiology department of the hospital, or is even outside the organisation, perhaps as an outsourced contract with another body. Connecting to the hospital network via a Virtual Private Network (VPN) provides the necessary link to PACS. Reporting on images in this way is a tried and tested process, having been utilised for many years by healthcare providers globally.

THE LIVE METHOD The live method of teleradiology is a relatively new area. In certain circumstances, there is need to quickly view and offer a first opinion on an x-ray or scan. These circumstances can include life threatening episodes such as trauma, stroke and cardiac conditions. In a pressured situation where time is of the essence, live teleradiology can save vital minutes and have a dramatic effect on patient outcomes. The use of a web based PACS, coupled with live unified communications (UC) based high definition telemedicine, provides the link between the radiologist and the consultant. The discussion of the

modality, the details of the case and the informed decision contributes to the treatment of case. The live, interactive, high quality interaction between professionals is the sharing of medical knowledge.

TELERADIOLOGY IN SUBSPECIALTIES Teleradiology, both live and in a stored and forward method, offers benefits to many specialties. As well as allowing the hospital system to choose how the images are reported and where the radiologists are based, it provides access to the expertise on a planned or ad hoc basis. One example is the continual

development of higher resolution scanners and manipulation software capable of interpreting more information from the radiology image. Digital Imaging and Communications in Medicine (DICOM) files, which store the digital information of the scan output, contain much more information than a 2D representation. Using advanced software techniques, the data of the DICOM file can be interpreted into high resolution 3D images, highlighting different textures, structures and can reveal certain aspects of the of the subject. Use of the software and interpreting the images into informed decisions requires lengthy training. Using UC to link the requesting specialist with a radiologist, the limited resource of the specialist knowledge can be shared across the region or even across the country.

TELERADIOLOGY IN CASE MANAGEMENT Away from emergency response, the live method of teleradiology has a place to contribute to planned discussion, such as in case 

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