Teleradiology was facing an impending threat. However, it has successfully evolved from the treat to traditional imaging to accepted practices improving access to patient care. Several departments have already used some form of reads from the outside, though experts believe that it is yet to reach the full potential.
A team of six experienced radiologists writes in the AJR that this ongoing pandemic has cemented the vital role of teleradiology in radiologic care, letting social distancing and tackling the surge in volume at the same time.
Moreover, in this present day of value-based medical care, using remote reading is only going to be more important.
According to Tarek N. Hanna along with the Department of Radiology and Imaging Sciences of the Emory University School of Medicine, the following challenges were highlighted for wider adoption:
License & Credentials
States oversee processes of licensure, stipulating radiologists and making them more familiar with the requirements to provide teleradiology services at transmitting sites as well as receiving sites. However, considering that several telerads are working at more than one hospital across the state line, the process could get extremely challenging.
Hanna and team said, “these barriers lead to practice inefficiencies as well as restricted access to subspecialty and emergent care, typically in the rural markets.”
And, whereas the Interstate Medical Licensure Compact made this easier for practicing physicians in various states, many densely populated states like California, Texas, Florida, and New York are not a part of this pact, which limits the impact.
Rules & Regulations
Several states have proven rules to regulate the components of the workflow of diagnostic radiology, which specifically hampers teleradiologists, according to the authors.
For instance, in New York City, diagnostic monitors used for distant reading are subject to periodic biweekly tests for quality control, intensive evaluations quarterly, and eventual annual testing. Only licensed and skilled medical physicists are allowed to carry this out. Predictably, some of the providers are eliminated because of their complexities and high costs needed for their at-home workstations, noted the authors. Minnesota and Washington are noted as the two states having fewer restrictive mandates.
Hanna and team explained, “We support the evidence-based regulations; regulation standardization across geography; and regulation not leading to disparities in quality of imaging care or its access. Radiologists have to stay engaged as they use their, collective or individual, voices for influencing regulatory legislation.”
Communication & System Integration
It is tough for teleradiologists to access all relevant data and clinical information because they interpret examinations from several institutions functioning on diverse PACS as well as electronic medical records. Efforts are taken to reduce a load of data-sharing obstacles without compromising the necessary security, with teleradiology networks, statewide being the only viable solution.
Besides, interpreting radiologists must oversee clinicians completing all imaging exams. Because they are distant, or remote, physicians should be particular and more vigilant to ensure easy and quick communication among themselves, ordering providers, and technologists. Virtual consultation with the facility of instant messaging is proven successful, explained the authors of the study.
Models for After-hours Staffing and Reimbursement Concerns
Night shifts are crucial to providing emergency imaging tests during wee hours. It is a primary driving force of the growth of teleradiology, noted the authors. However, such hours of work often result in dissatisfaction, making it difficult to recruit overnight service providers.
Besides, while there are several new models for clinical scheduling evolving to compensate for non-traditional schedules, working after work hours is seldom a part of the code of Current Procedural Terminology. Hence, the clinical production of such rads is unfairly discounted.
Hanna and her colleagues wrote, “Radiologists should be working with specialty societies and address care discrepancies, with a clear understanding that it might involve rigorous staffing, for both technologists and physicians, after-hours. And, such a change might require culture shifts in the workplace as well as support from reimbursement models.
The market of teleradiology is predicted to grow persistently, and keeping these issues ashore can help in ensuring broader and better access to high-quality imaging solutions across the country, according to the authors.
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