What are the pitfalls you would encounter when you transition into a 24/7 Teleradiology Coverage ? For more info on how we can help you . contact info@telradsol.com

1. Transitioning to 24/7
coverage
Practice Model: Teleradiology
Anjali Agrawal, MD
Senior Consultant, Teleradiology Solutions
Adjunct Faculty, Baylor College of Medicine, Houston
Joint Secretary, Society for Emergency Radiology

2. Teleradiology-Evolution
• Digitization of radiology images –transformed
radiology practices, and made teleradiology feasible
• Evolved rapidly hand-in-hand with the internet in the
1990’s
• PACS and ease of image transfer and sharing
promoted acceptance. “Teleradiology shifted from
being a technical curiosity to a clinical tool”*
• Today, 50% of hospital based radiology practices
utilize teleradiology service providers in addition to
hospital to home use
* Thrall JH. Teleradiology: two edged sword or friend of radiology practice? J AM Coll Radiol.2009 Feb; 6(2)

3. Teleradiology-Thriving Practice Model
• Fuelled by shortage of radiologists, increasing imaging
volumes, demand for subspecialized reads
• Imaging has become a central part of modern
medicine
• Different lifestyle expectations of radiologists -
”Controllable Lifestyle”
– Outsourcing reads during uncomfortable work
hours makes practices more lucrative
Hillman BJ. International teleradiology and new workforce expectations. J Am Coll Radiol. 2005 Feb;2(2):103-4
Dorsey ER, Jarjoura D, Rutecki GW. Influence of controllable lifestyle on recent trends in specialty choice by US medical
students. JAMA 2003;290:1173-1178

4. Teleradiology-Friend or Foe?
• From whose perspective?
– US based general radiologist
• Big practice
• Small practice
– US based specialized radiologist / teleradiologist
– Patient
– Hospital
– ER staff
– Global radiologist

5. Teleradiology-Patient’s Perspective
• Quick availability of radiological services 24/7
• Access to specialty radiologists from anywhere
• Probably, better pricing
Pros
Cons
• In unregulated environments, quality assurance can
be a concern
• Reduced communication between clinical team and
radiologist may happen

6. Teleradiology: Radiologist’s friend
• A blessing for smaller practices
• Subspecialty opinions in groups where there aren’t
any
• Improved lifestyle
• Ability to take your work anywhere

7. Teleradiology: Radiologist’s foe?
• Reduced exposure to emergent
cases
– Unhealthy for personal
academic growth
– Reduced role and
connectivity within
organization
• Reduced revenues may become
a consideration in coming years
• Commoditization and
consolidation of Radiology???
Boland GWL. Teleradiology coming of age: Winners and Losers. AJR2008;190:1161-1162

8. Teleradiology- Driving commoditization of Radiology?
• Commoditization only if the client
radiology groups or hospitals fail to
recognize the intrinsic quality
associated with radiology services
• Once commoditized in the eye of the
client, financial pressures to provide
low prices will further commoditize
radiology, setting up a vicious cycle
• Reduced quality standards, poorer
patient care, and overall discontent
Boland GWL. Teleradiology for Auction:The Radiologist Commoditized and How to Prevent it. J Am Coll Radiol. 2009
Leung DPY, Dixon AK. Clinicoradiological meetings:are they worthwhile? Clin Radiol 1992;46:279-80
Commoditization: a state where a product has minimal intrinsic quality
attributes and can be bought similarly from many equivalent vendors

9. Getting the best from teleradiology towards
24/7 coverage
• Teleradiologists
– Stringent QA process-review of reports and
regular comparative audits
– Precise pathways of communication of urgent or
unexpected findings
– Availability to on-site clinical staff: contact phone
number
– Maintenance of certification, licensure,
credentialing, adherence to all regulations
QUALITY IS NOT AN ACT. IT'S A HABIT.

10. Getting the best from teleradiology towards 24/7 coverage
• Radiology groups
– Evaluation of external teleradiology services on
quality
– Active feedback and dialogue with teleradiology
providers
– Active engagement with clinical and educational
programs
– Maintenance of skills in emergent radiology

11. Conclusion
• Teleradiology is a good practice model for 24/7 coverage
– Patients benefit
– Radiologists can have improved lifestyle in certain situations
without compromising their role either as a doctor’s doctor or a
patient’s physician
– Adherence to QA and self regulation can prevent potential
commoditization related ills

12. Conclusion
Synergy and appropriate use can enhance and optimize radiology
services

13. Dr. Anjali Agrawal is a consultant radiologist to Teleradiology
Solutions, where she heads the Delhi Operations of the
group. She graduated in medicine from the All India Institute
of Medical Sciences followed by Radiology training at AIIMS
and the Baylor College of Medicine, Houston, Texas. She is
actively involved in the American Society of Emergency
Radiology and is one of the founder members of the Society
for Emergency Radiology in India.
About Dr. Anjali
Anjali Agrawal, MD
anjali.agrawal@telradsol.com