Teleradiology gives 24/7 boost to small groups
Teleradiology gives 24/7 boost to small groups
For years, Robert Lefsrud, MD, a radiologist with a subspecialty in neuroradiology and musculoskeletal radiology, was a member of a large and busy radiology group providing services in the Twin Cities area of Minnesota. Two years ago, he and a colleague decided to branch out and form their own company, St. Croix Radiology Consultants in Dellwood, MN.
Over the years, Lefsrud has seen radiology transformed into a 24/7 practice in which radiologists can be called at all hours to provide services. But, instead of hiring more radiologists to provide round-the-clock coverage to two client hospitals and other facilities to meet that demand, his new company went virtual. Outside of the usual business hours, it uses a teleradiology services provider for assistance with CT, nuclear medicine, ultrasound, MRI, and radiographic images.
Lefsrud and his partner (who are assisted by two part-time radiologists) are working 7 a.m. to 5 p.m. shifts on weekdays, with nights, weekends, and holidays taken off. Providing coverage during those hours is a team of 27 radiologists hundreds and even thousands of miles away across the country employed by Virtual Radiologic Corp. (VRC) of Minnetonka, MN. VRC has hundreds of clients serving nearly 800 medical facilities.
"What keeps a lot of people now in large groups is the issue of coverage," Lefsrud says. "With VRC or companies like it, smaller groups are more feasible."
So what should a radiologist look for when selecting a company to provide teleradiology services?
• Time. Lefsrud was interested in delivery time. For example, how long did it take from transmitting the image to receiving a preliminary read? When his company did an audit of 1,000 cases, it found that the average turnaround time was about 18 minutes. With his previous employer, that time was a little over an hour.
• Paperwork. Each physician that provides a service to a hospital must be accredited by the hospital and licensed by the state, even if that physician is located and is performing the actual services in another state or another country. To help speed along this process (and reduce paperwork), VRC has been accredited by The Joint Commission.
This accreditation means that VCR completes strict licensing and credentialing verifications, to comply with Joint Commission health care quality and safety standards, before the teleradiologists' services are offered. "This makes the accrediting process simpler for our hospitals. Otherwise, it would be a lot of paperwork," Lefsrud says.
• Quality control. On average, the teleradiologists read about five images on weeknights and 20 on weekends. When Lefsrud's group analyzed quality control, they found that major discrepancies occurred only less than 1% of the time. These did not result in any adverse effects, he says.
"We also have the option to ask, if we're unhappy with any particular reader, that they not read for us," he says. "But that hasn't been necessary."
• Privacy issues. Any company providing teleradiology should make it clear how patient privacy is being ensured, such as through record encryption or secure server systems, to comply with Health Insurance Portability and Accountability Act (HIPAA) regulations.
Since NightHawk Radiology Services of Coeur d'Alene, ID, first started the teleradiology trend a decade ago, using U.S.-trained physicians based in Sydney, Australia, to read radiological images transmitted through high-speed lines during nighttime hours from the United States, the interest has been high in this area.
The trend to use teleradiology in some fashion, whether internally through group or regional practices or with a large teleradiology company, has been on the rise, says Arl Van Moore, MD, president of Charlotte (NC) Radiology and chairman of the American College of Radiologist's Board of Chancellors. However, it's a market that has been consolidating in recent years, which has created concerns that some of the larger publicly-traded teleradiology companies may be more interested in answering shareholders rather than radiological groups, he says.
It's also a market that has expanded beyond the borders of the United States, which has created a new set of legal, regulatory, and even quality issues that need to be monitored. "Quality has always got to be an issue. The problem is how do you monitor it — especially in a foreign country half a world away," Moore says. "There's no jurisdiction in the U.S. or other countries of how we do it."
A change in the teleradiological services market also may be ahead as the adult market "comes to a point of saturation," says Shehnaz Pancholi, CEO and founder of Teleradiology America and Pediatric Radiology of America with headquarters in Roanoke, VA. This saturation may mean a greater emphasis on radiology subspecialties, such as pediatrics or cardio imaging. "With more technology coming out, it's going to be fairly easier for people to provide virtual subspecialty care," she says.
For years, Robert Lefsrud, MD, a radiologist with a subspecialty in neuroradiology and musculoskeletal radiology, was a member of a large and busy radiology group providing services in the Twin Cities area of Minnesota. Two years ago, he and a colleague decided to branch out and form their own company, St. Croix Radiology Consultants in Dellwood, MN.Subscribe Now for Access
You have reached your article limit for the month. We hope you found our articles both enjoyable and insightful. For information on new subscriptions, product trials, alternative billing arrangements or group and site discounts please call 800-688-2421. We look forward to having you as a long-term member of the Relias Media community.