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Let quality be the driving force of teleradiology rather than monetary benefit

An article entitled Teleradiology- The Indian Perspective published in the Indian Journal of Radiology Imaging brings up some of the important issues in the teleradiology space in India. The author, Arjun Kalyanpur, Chief Radiologist & CEO of Teleradiology Solution describes the various challenges and opportunities infront of India in the context of teleradiology. Teleradiology as an outsourcing option from more developed countries to India, there has been an exciting development in the last decade that has truly put India on the world map of quality healthcare. But still the the author believes that teleradiology sphere has lot grow lot more in India.

The author considers teleradiology in the Indian setting in two completely separate contexts. The first is the ability of teleradiology to provide new economic opportunity for India and the other one and perhaps the most significant role is providing a potential solution to the staffing shortages that the radiology community in India, face today and will continue to face with increasing severity in the coming years. India has a proven record in the world teleradiology space through its consistent performance over the past six years. And India is also well known for the quality of reporting, a caliber equal or superior to that provided by western companies. The time zone advantages also supplemented success. But then, this hard-earned reputation has lately been jeopardized by controversial hard-sell advertising by some newer Indian players.

The author recalls that at the Radiology Society of North America (RSNA) meeting , he repeatedly heard from radiologists in the US and Europe who had received mass mailings from providers in India offering ‘low cost, high quality preread’ services. He cited and example that pointed out how badly written the message was, containing numerous typographical and syntax errors. And the author reproduces the woes of a US radiologist here-when an introductory email is itself so shoddy, what quality expectation can there be of the radiology reports? And another matter of concern was the email also contained an insinuation that the reports would be “of such high quality that no additional review by a European or American radiologist would be necessary”. Such advertisements and offers has put the entire country in disrepute and the industry in jeopardy.

To all who wish to enter the teleradiology providers market, Arjun Kalyanpur recommends that they should neccessarily understand the regulations and implications carefully and thoroughly before they plunge in. International regulations vary greatly from country to country and so what is appropriate in one location may be entirely inappropriate in another. Attending an accredited Teleradiology symposium or session at a national or international conference is one way to familiarize oneself with the issues involved.

It is neccessary to understand that every country has its own licensure requirements. Any preliminary ‘preread’ report would therefore have to be reviewed again by the onsite radiologist. The process of dual review or ‘preread’ in which a preliminary report by a trained professional (radiologist, technologist or physician assistant) is overread by a radiologist licensed in that country, who reviews the study in toto, results in an efficiency, productivity and quality benefit,  This model is now largely an accepted one - as opposed to the specter that has been raised of “ghost reporting” in which the licensed radiologist does not review the study but simply “signs off”.

The discussion also goes to the use of teleradiology within India to benefit underserved areas, especially in emergency situations, to increase the reach of subspecialty diagnosis and to ease regional and temporal staffing shortages. Given the grossly inadequate ratio in India where 1 radiologist to 100,000 people, the use of technology is critical to address these issues. Such efforts may bring great relief and can be done at relatively low cost. Though there are successful  ventures, a robust business model is not in place for such services within India, likely due to cost constraints,and so the greatest value is likely to be in the not-for-profit sector (for example, our services to the RKMH are entirely free of charge).

Better utilization of radiologist time and efficiency measures are inherent to the practice of teleradiology, both of which can help to significantly enhance radiologist productivity. The author concludes that there are two broad guidelines that we must follow if we are to truly reap the benefits of teleradiology – a) follow the rules and b) let quality and not monetary benefit be the driving force.

Source: Indian Journal of Radiology Imaging

You can discuss more about Teleradiology and related topics in our Teleradiology Group