[Externally Acquired Radiological Image Data and Reporting for the Clinical Routine, Conference and Boards - Legal Aspects of the Second Opinion in Germany]. / Externe radiologische Aufnahmen und Befunde in der klinischen Routine, Konferenzen und Boards ­ rechtliche Aspekte der Nachbefundung und Zweitmeinung in Deutschland.

BACKGROUND: Because of an increasing number of boards and conferences, the number of second opinion readings of externally acquired image data is growing dramatically. In this review article we intend to give medical and legal recommendations for the documentation and interpretation of externally acquired radiological data for second opinions and board presentations based on German jurisdiction. METHOD: Using the FAQ format as a dialog between radiologists and medical legal experts, we answer the most crucial questions regarding correct documentation and interpretation for externally acquired radiological image data based on an up-to-date literature search. RESULTS: Based on the unity of radiological image data and the corresponding written report according to the radiation protection law, the primary report should be present when composing a second opinion. If the primary external report is not present, this should be mentioned as a limitation. All radiological second opinions should be documented in written form. This is especially important in cases of discrepant findings. Legally, the attending physician is responsible for selecting the radiological opinion. The radiologist should not rely on the written primary report without personal reevaluation. Legally, it would be considered radiological malpractice if the external image data and previous image data are not evaluated personally. CONCLUSION: From a legal point of view, there are explicit recommendations regarding thorough documentation of a second opinion as an independent medical service in all cases.

Externally Acquired Radiological Image Data and Reporting for the Clinical Routine, Conference and Boards - Legal Aspects of the Second Opinion in Germany. / Externe radiologische Aufnahmen und Befunde in der klinischen Routine, Konferenzen und Boards ­ rechtliche Aspekte der Nachbefundung und Zweitmeinung in Deutschland.

BACKGROUND: Because of an increasing number of boards and conferences, the number of second opinion readings of externally acquired image data is growing dramatically. In this review article we intend to give medical and legal recommendations for the documentation and interpretation of externally acquired radiological data for second opinions and board presentations based on German jurisdiction. METHOD: Using the FAQ format as a dialog between radiologists and medical legal experts, we answer the most crucial questions regarding correct documentation and interpretation for externally acquired radiological image data based on an up-to-date literature search. RESULTS: Based on the unity of radiological image data and the corresponding written report according to the radiation protection law, the primary report should be present when composing a second opinion. If the primary external report is not present, this should be mentioned as a limitation. All radiological second opinions should be documented in written form. This is especially important in cases of discrepant findings. Legally, the attending physician is responsible for selecting the radiological opinion. The radiologist should not rely on the written primary report without personal reevaluation. Legally, it would be considered radiological malpractice if the external image data and previous image data are not evaluated personally. CONCLUSION: From a legal point of view, there are explicit recommendations regarding thorough documentation of a second opinion as an independent medical service in all cases. KEY POINTS: · The written external report should be present when composing a second opinion report or case presentation.. · Second opinions or external case interpretations should be documented in written form.. · It is considered malpractice to completely rely on the external written report for a second opinion.. · In discrepant radiological findings the treating physician is responsible for choosing the correct radiological interpretation.. CITATION FORMAT: · Schreyer AG, Rosenberg B, Steinhäuser RT. Externally Acquired Radiological Image Data and Reporting for the Clinical Routine, Conference and Boards - Legal Aspects of the Second Opinion in Germany. Fortschr Röntgenstr 2018; 190: 610 - 615.

Externally Acquired Radiological Data for the Clinical Routine - A Review of the Reimbursement Situation in Germany.

BACKGROUND: Interdisciplinary radiological conferences and boards can improve therapeutic pathways. Because of the reinterpretation and presentation of external image data, which already was read, an additional workload is created which is currently not considered by health care providers. In this review we discuss the ongoing basics and possibilities in health economy for a radiological second opinion for the outpatient and inpatient sector in Germany. METHOD: Based on up-to-date literature and jurisdiction, we discuss the most important questions for the reimbursement for second opinions and conference presentations of external image data in an FAQ format. Additionally, we focus on the recently introduced E-Health law accordingly. RESULTS: Radiological services considering second opinion or board presentation of externally acquired image data are currently not adequately covered by health care providers. In particular, there is no reimbursement possibility for the inpatient sector. Only patients with private insurance or privately paid second opinions can be charged when these patients visit the radiologist directly. CONCLUSION: Currently there is no adequate reimbursement possibility for a radiological second opinion or image demonstrations in clinical conferences. It will be essential to integrate adequate reimbursement by health care providers in the near future because of the importance of radiology as an essential diagnostic and therapeutic medical partner. KEY POINTS: · Currently there is no reimbursement for image interpretation and presentation in boards.. · Second opinions can only be reimbursed for patients with private insurance or privately recompensed.. · The E-Health law allows reimbursement for tele-counsel in very complex situations.. · It will be crucial to integrate radiological second opinion in future reimbursement policies by health care providers.. CITATION FORMAT: · Schreyer AG, Steinhäuser RT, Rosenberg B. Externally Acquired Radiological Data for the Clinical Routine - A Review of the Reimbursement Situation in Germany. Fortschr Röntgenstr 2018; DOI: 10.1055/s-0044-101552.