Despite teleradiology's promise, evolution still necessary

The issue of teleradiology's place in the medical imaging industry still evokes a bit of a mixed reaction among radiology professionals. Just take a look at my recent interview with teleradiology critic David C. Levin, M.D., who calls the practice "a very bad thing for radiology, particularly for medium- and large-sized groups."

It is clear that many radiologists look wearily upon predatory practices by some teleradiology companies who, instead of providing support in the form of night calls and subspecialty reads, look to supplant radiology practices completely. And there are accompanying concerns about commoditization of the specialty, as well as the impact on reimbursements. Levin also mentions that there could be quality concerns associated with teleradiology.

But recent literature on the subject may allay some of the latter concerns.

A study presented earlier this year at the European Congress of Radiology indicates that, in fact, teleradiology services are very reliable when it comes to reading after hour CT studies. The study, by Joachim Hohmann, M.D.--a radiologist at University Hospital of Basel in Switzerland--looked at more than 1,000 patients over a five-month period at the University College Hospital in London, and found lower than a 1 percent rate of serious missed interpretations.

"I don't have any quality concerns about a teleradiology approach for emergency examinations," Hohmann said, according to an article in RSNA News.

What's more, the American College of Radiology's Task Force on Teleradiology Practice in May published a white paper outlining several best practices. The authors of the white paper were quite clear that they weren't taking sides on business conflicts, but also suggested that onsite radiologists should ensure they are meeting expectations and providing value so that hospitals won't be looking to replace them.

Teleradiology companies, the authors also said, should be held to the same quality and safety standards as onsite radiologists. 

To be clear, teleradiology isn't going anywhere. The specialty would be seriously disrupted if such companies suddenly disappeared, since they play a critical role in handling night coverage and filling in subspecialty gaps for smaller practices.

I'd like to see the practice can continue to evolve, though, to the point where such debates are no longer necessary. Telemedicine continues to gain ground in the healthcare industry, at large, so why can't similar hope be held out for specialty of radiology? - Mike  @FierceHealthIT