Associations between 24/7 workforce coverage, organizational challenges, and well-being of emergency radiologists: a national survey.

BACKGROUND: The last decade has seen a surge in the demand for imaging exams in emergency radiology (ER), necessitating an evolution in organizational systems for departments offering round-the-clock care, while safeguarding patient care quality and physician well-being to prevent burnout. PURPOSE: To develop a nationwide overview of ER organizations in France and identify structures that promote job satisfaction. MATERIAL AND METHODS: Two surveys were sent to 709 radiological centers across France from March to June 2022, inquiring about organizational aspects and quality of life (QOL), incorporating four validated QOL questionnaires. The organization of each center was mapped, and correlations between respondent characteristics and mental health were analyzed using Pearson's and Wilcoxon tests. RESULTS: A total of 284 centers answered the organizational survey, with a response rate of about 41.6%. Among them, there were 32 university hospitals, 208 general hospitals, 2 teaching army hospitals, and 42 private facilities. Of these, night-time operations showed 14% on-site coverage, 12% on-call from home, 69% utilized external teleradiology, and 4% used in-house teleradiology. These trends persisted over weekends and holidays. Regarding the quality of working life, academic, general, and private radiologists are more satisfied with their practice compared to trainees. Depersonalization, part of the three dimensions of burnout, was high in every class, at 60% (n = 210/350). CONCLUSION: Outside of university hospitals, most radiology centers in France no longer have on-site radiologists during off hours. Residents are prone to lower job satisfaction and quality of life than more experienced radiologists. CLINICAL RELEVANCE STATEMENT: The survey illustrates how French ER is structured, pointing out the escalating significance of teleradiology and noting that radiologists generally experience high job satisfaction while also confronting typical organizational challenges. KEY POINTS: The need for continuous radiology coverage comes with unique logistical challenges, especially in ER. Night shifts show a significant reliance on teleradiology services, especially by external companies. Pay, shift patterns, and seniority affect the well-being of emergency radiologists, particularly the residents.

Emerging technologies in pediatric radiology: current developments and future prospects.

Radiological imaging is a crucial diagnostic tool for the pediatric population. However, it is associated with several unique challenges in this age group compared to adults. These challenges mainly come from the fact that children are not small-sized adults and differ in development, anatomy, physiology, and pathology compared to adults. This paper reviews relevant articles published between January 2015 and October 2023 to analyze challenges associated with imaging technologies currently used in pediatric radiology, emerging technologies, and their role in resolving the challenges and future prospects of pediatric radiology. In recent decades, imaging technologies have advanced rapidly, developing advanced ultrasound, computed tomography, magnetic resonance, nuclear imaging, teleradiology, artificial intelligence, machine learning, three-dimensional printing, radiomics, and radiogenomics, among many others. By prioritizing the unique needs of pediatric patients while developing such technologies, we can significantly alleviate the challenges faced in pediatric radiology.

Assessing the impact of trained Radiologist Assistants in a busy emergency teleradiology practice: a comprehensive evaluation.

PURPOSE: This study aims to study the feasibility and usefulness of trained Radiologist Assistants in a busy emergency teleradiology practice. METHOD: This is a retrospective study over a 21-month period (January 2021 to September 2022). The study analysed archived data from 247118 peer review studies performed by Radiologist Assistants (RAs) out of a total case volume of 828526 and evaluated the rate of discrepancies, the study types commonly noted to have discrepancies, and the severity of errors. These missed findings were brought to the attention of the radiologists for approval and further decision-making. RESULTS: Peer review by RAs was performed on 30% (n = 247118) of the total volume 828526 studies reported, and yielded additional findings including but not limited to fractures (218; 23%), hemorrhage,(94; 10%) pulmonary thromboembolism, (n = 104; 11%), Calculus (n = 75; 8%) lesion (n = 66; 5%), appendicitis(n = 50; 4%) and others. These were brought to the attention of the radiologist, who agreed in 97% (1279 out of 1318) of cases, and communicated the same to the referring facility, with an addended report. CONCLUSION: Trained RAs can provide value to the peer review program of a busy teleradiology practice and decrease errors. This may be useful to meet the ongoing radiologist shortages.

Patient preferences for teleradiology services and remote image interpretation: An empirical study.

STUDY PURPOSE: This study aims to examine patient preferences for teleradiology services and remote image interpretation. In this context, this study aims to address the following research questions: (i) How do patients perceive teleradiology services, focusing specifically on comfort, quality of care and satisfaction, communication and information, and accessibility and ease of use; (ii) How do patient demographics (age, gender, urban vs. rural residence) influence the perceptions on teleradiology services? METHODS: A cross-sectional survey design is adopted in this study. The survey comprises five sections targeting demographic information, comfort, and preferences regarding remote image interpretation, perceived quality of care and satisfaction, communication and information clarity, and accessibility and technology aspects using five-point Likert scale ratings. A total of 406 patients (209 males and 197 females; 170 urban residents; 174 semi-urban residents, and 62 rural residents) using teleradiology services participated in the study. RESULTS: Participants reported high satisfaction with remote image interpretation (3.78 ± 1.19), quality of care (3.31 ± 1.19), understanding (3.84 ± 1.43), and user-friendliness (3.67 ± 1.29). Key issues were technical problems (3.81 ± 1.35), feedback difficulties (3.19 ± 1.58), privacy concerns (2.43 ± 1.46), and low awareness (2.37 ± 1.12). Urban participants scored significantly better in comfort, preferences, and communication than those from semi-urban and rural areas. CONCLUSION: Teleradiology design and implementation should be optimized to align with patient preferences and enhance overall satisfaction.

ACVR and ECVDI consensus statement for teleradiology.

Increased demand for the interpretation of diagnostic images by board-certified radiologists and profound advancements in technology have led to extremely rapid growth in the field of veterinary teleradiology over the past decade. The aim of this consensus statement is to provide a guideline for best practices for quality and safety in veterinary teleradiology. The statement addresses appropriate image acquisition and transmission, the creation of teleradiology submissions, quality control in teleradiology, and appropriate documentation of imaging reports, as deficiencies in any of these areas may directly affect the standard of patient care. The consensus statement may be used as a guide for radiologists, primary care veterinarians, technicians, and students for the use of teleradiology in practice.

The Virtual Reality Radiology Workstation: Current Technology and Future Applications.

Virtual reality (VR) and augmented reality (AR) technology hold potential across many disciplines in medicine to expand the delivery of education and healthcare. VR-AR applications in radiology, in particular, have gained prominence and have demonstrated advantages in many areas within the field. Recently, VR software has emerged to redesign the physical radiology workstation (ie, reading room) to expand the possibilities of diagnostic interpretation. Given the novelty of this technology, there is limited research investigating the potential applications of a simulated radiology workstation. In this review article, we explore VR-simulated reading room technology in its current form and illustrate the practical applications this technology will bring to future radiologists and learners. We also discuss the limitations and barriers to adopting this technology that must be overcome to truly understand its potential benefits. VR reading room technology offers great potential in radiology, but further research is needed to appreciate its benefits and identify areas for improvement. The findings and insights presented in this review contribute to the ongoing discourse on future technological advancements in radiology and healthcare, offering valuable recommendations for further research and practical implementation.

Teleradiology: Geography is now History!

How to cite this article: Ramakrishnan N. Teleradiology: Geography is now History! Indian J Crit Care Med 2024;28(1):1-2.

Utilization of Teleradiology by Intensive Care Units: A Cohort Study.

Aim and background: Imaging is indispensable to the diagnostic and treatment process. By facilitating access to rapid timely image interpretation, teleradiology plays a prominent role in improving access, quality of critical care, and management of the patients in intensive care units (ICU). The aim of the study is to investigate the role of teleradiology in ICU patient care and management. Materials and methods: In our study, a total of 22,081 studies of a cohort of 14,900 patients which had been transmitted from intensive care units of 80 hospitals located across the United States of America through a teleradiology reporting workflow, were interpreted by the American Board Certified Radiologists empanelled by a teleradiology service provider, located in India. Results: Among all modalities, the highest percentage of studies performed were computed tomography scan (47%) followed by radiographs (37.22%). Out of 22,081 cases under the study, 16,582 cases were reported during nighttime with a mean turnaround time (TAT) of 46.66 minutes 95% CI (46.27-47.04) while 5,499 cases were reported during daytime with a mean TAT of 44.66 minutes 95% CI (45.40-43.92). Conclusion: Setting up teleradiology service connectivity with a teleradiology service provider located in India, providing high-quality diagnostic interpretations and lower turnaround time with the ICUs in the US hospitals reduces the interval to intervention time and leads to efficient patient care management. Moreover, it also provides time advantage for US hospitals when on-site radiologists at night are unable to provide immediate coverage. Clinical significance: The ICU teleradiology service model designed in the study would greatly help overcome the shortfall of radiologists in the hospitals, provide better patient management and care by quality reporting in short turnaround time, not only during daytime but also in the night hours or on holidays when on-site radiologists are unable to provide immediate coverage. How to cite this article: Rao P, Mathur N, Kalyanpur A. Utilization of Teleradiology by Intensive Care Units: A Cohort Study. Indian J Crit Care Med 2024;28(1):20-25.

Acute management of fractures in primary care - a cost minimisation analysis.

BACKGROUND: In Norway, primary healthcare has first-line responsibility for all medical emergencies, including traumas and fractures. Normally, patients with suspected fractures are referred to specialist care in hospitals. However, the cooperating municipalities of Bykle and Valle have X-ray facilities and handle minor fractures locally. The aim of this study was to estimate the costs of X-ray diagnosis and initial treatment of fractures at the local primary care centre compared with initial transport and treatment in hospital. METHODS: We conducted a cost minimisation analysis by comparing expected costs of initial examination with X-ray and treatment of patients with fractures or suspected fractures at two possible sites, in the local municipality or at the hospital. A cost minimisation analysis is an economic evaluation based on the assumption that the outcomes of the two treatment procedure regimens are equal. Costs were estimated in Euros (EUR) using 2021 mean exchange rates. RESULTS: In 2019, we identified a total of 403 patients with suspected fractures in the two municipalities. Among these, 12 patients bypassed the primary care system as they needed urgent hospital care. A total of 391 injured patients were assessed with X-ray at the primary health care centres, 382 received their initial treatment there, and nine were referred to hospital. In an alternative hospital model, without X-ray and treatment possibilities in the municipality, the 382 patients would have been sent directly to hospital for radiological imaging and treatment. The total cost was estimated at EUR 367,756 in the hospital model and at EUR 69,835 in the primary care model, a cost saving of EUR 297,921. CONCLUSION: Based on cost minimisation analysis, this study found that radiological diagnosis of suspected fractures and initial treatment of uncomplicated fractures in primary care cost substantially less than transport to and treatment in hospital.

Daytime, evening, and overnight: the 24-h radiology cycle and impact on interpretative accuracy.

PURPOSE: To assess the influence of time of day when a study is interpreted on discrepancy rates for common and advanced studies performed in the acute community setting. METHODS: This retrospective study used the databank of a U.S. teleradiology company to retrieve studies between 2012 and 2016 with a preliminary report followed by a final report by the on-site client hospital. Neuroradiology, abdominal radiology, and musculoskeletal radiology studies were included. Teleradiologists were fellowship trained in one of these subspecialty areas. Daytime, evening, and overnight times were defined. Associations between major and minor discrepancies, time of day, and whether the study was common or advanced were tested with significance set at p = .05. RESULTS: A total of 5,883,980 studies were analyzed. There were 8444 major discrepancies (0.14%) and 17,208 minor discrepancies (0.29%). For common studies, daytime (0.13%) and evening (0.13%) had lower major discrepancy rates compared to overnight (0.14%) (daytime to overnight, RR = 0.57, 95%CI: 0.45, 0.72, p < 0.01 and evening to overnight, RR = 0.57, 95%CI: 0.49,0.67, p < 0.01). Minor discrepancy rates for common studies were decreased for evening (0.29%) compared to overnight (0.30%) (RR = 0.89, 95%CI: 0.80,0.99, p = 0.029). For advanced studies, daytime (.15%) had lower major discrepancy rates compared to evening (0.20%) and overnight (.23%) (daytime to evening, RR = 0.77, 95%CI: 0.61, 0.97, p = 0.028 and daytime to overnight, RR = 0.66, 95%CI: 0.50, 0.87, p ≤ 0.01). CONCLUSION: Significantly higher major discrepancy rates for studies interpreted overnight suggest the need for radiologists to exercise greater caution when interpreting studies overnight and may require practice management strategies to help optimize overnight work conditions. The lower major discrepancy rates on advanced studies interpreted during the daytime suggest the need for reserving advanced studies for interpretation during the day when possible.

Role of emergency teleradiology in a mass motorcycle event: the experience of the 2021 International Six Days of Enduro (ISDE).

PURPOSE: Provision of healthcare support at mass gathering sporting events is of paramount importance for the success of the event. Many of such events, like motorsports, have been increasingly taking place in remote and austere environments. In these settings, the use of first-line diagnostic tools, such as point of care ultrasound and portable X-ray, could aid in definitive care on the field for patients with minor trauma while also ensuring fast access to the appropriate level of care for patients requiring hospitalization. METHODS: As part of the ISDE 2021 medical response plan, a field hospital equipped with portable digital X-ray and telemedicine was established. Data on patient admission, triage, treatments, diagnostics, and outcomes were collected for analysis. RESULTS: During the 6-day competition, 79 patients sought medical care at the field hospital, with traumatic injuries accounting for 77% of cases. Of these, 47 were athletes and 32 were non-athletes. The majority (91%) arrived spontaneously, while 9% were transported directly. Upon admission, 68 patients were triaged as non-urgent (code 3) and 11 as urgent (code 2). Of those admitted, 69 received treatment and were discharged at the field hospital, while 10 were transferred elsewhere. Notably, four patients had major trauma, two had isolated fractures, and one needed a CT scan after losing consciousness. Overall, 29 missions were conducted on the race field, including 13 primary transports to local hospitals and 6 to the field hospital. Primary transport was primarily due to major trauma. Among 31 patients who had radiological exams, 11 (35.5%) had traumatic injuries. Of these, 5 were treated with braces and casts and discharged without hospitalization, 3 were advised for post-event care, and 3 were hospitalized. In contrast, patients with negative X-rays received on-site treatment, with 7 able to continue competing. CONCLUSIONS: In summary, the successful implementation of portable X-ray machines and teleradiology at remote and austere high-risk sporting events holds great promise for enhancing on-site medical capabilities, allowing clinicians informed decisions, avoiding unnecessary hospitalization, and allowing athletes to continue with their competition. Provided that challenges related to cost, safety, connectivity, and power supply are effectively addressed.

Radiological management and challenges of the twin earthquakes of February 6th.

Two major earthquakes measuring 7.8 and 7.7 on the Richter scale struck Turkey and Northern Syria on February 6, claiming more than 50,000 lives. In such an unprecedented disaster, radiologists were confronted with very critical tasks of stepping out of the routine reporting process, performing radiological triage, managing acute adverse events, and optimizing imaging protocols. In our experience, radiologists can take three different positions in such disasters: (1) in the scene of the disaster, (2) serving in teleradiology, and (3) working in tertiary hospital for transported patients. With this article, we aimed to describe the challenges radiologists face on the three main fronts and how we manage these challenges.

The growing role of telemedicine - possibilities and regulations concerning teleradiology in Poland.

In recent years, imaging studies have become increasingly used at various stages in the management of patients with various conditions and disorders. This process results in a necessity to provide an increasing number of exams, which involves a growing role of radiologists in assessing and reporting those exams. The article discusses tele-radiology as a method that can improve access to radiology services, presenting its potential benefits, as well as the risks involved. It analyses access to radiology healthcare services in Poland in the context of the international and Polish legal provisions concerning the right to healthcare. While funding for imaging studies for patients is widely available and imaging equipment in Poland is improving despite some shortages, the main barrier is identified in the number of specialists capable of assessing the exams. Teleradiology can alleviate this shortage, so the article presents legal provisions and international good practice guidelines in this area, focusing on documents issued by the European Society of Radiology, the American College of Radiology, and the British Royal College of Radiologists. The guidelines concerning such aspects as patients' rights, teleradiologists' qualifications, communication and reporting, responsibility, and technical requirements may help make teleradiology a safe and valuable component of the healthcare system in Poland.

Interpretations of Examinations Outside of Radiologists' Fellowship Training: Assessment of Discrepancy Rates Among 5.9 Million Examinations From a National Teleradiology Databank.

BACKGROUND. In community settings, radiologists commonly function as multispecialty radiologists, interpreting examinations outside of their area of fellowship training. OBJECTIVE. The purpose of this article was to compare discrepancy rates for preliminary interpretations of acute community-setting examinations that are concordant versus discordant with interpreting radiologists' area of fellowship training. METHODS. This retrospective study used the databank of a U.S. teleradiology company that provides preliminary interpretations for client community hospitals. The analysis included 5,883,980 acute examinations performed from 2012 to 2016 that were preliminarily interpreted by 269 teleradiologists with a fellowship of neuroradiology, abdominal radiology, or musculoskeletal radiology. When providing final interpretations, client on-site radiologists voluntarily submitted quality assurance (QA) requests if preliminary and final interpretations were discrepant; the teleradiology company's QA committee categorized discrepancies as major (n = 8444) or minor (n = 17,208). Associations among examination type (common vs advanced), relationship between examination subspecialty and the teleradiologist's fellowship (concordant vs discordant), and major and minor discrepancies were assessed using three-way conditional analyses with generalized estimating equations. RESULTS. For examinations with a concordant subspecialty, the major discrepancy rate was lower for common than for advanced examinations (0.13% vs 0.26%; relative risk [RR], 0.50, 95% CI, 0.42-0.60; p < .001). For examinations with a discordant subspecialty, the major discrepancy rate was lower for common than advanced examinations (0.14% vs 0.18%; RR, 0.81; 95% CI, 0.72-0.90; p < .001). For common examinations, the major discrepancy rate was not different between examinations with concordant versus discordant subspecialty (0.13% vs 0.14%; RR, 0.90; 95% CI, 0.81-1.01; p = .07). For advanced examinations, the major discrepancy rate was higher for examinations with concordant versus discordant subspecialty (0.26% vs 0.18%; RR, 1.45; 95% CI, 1.18-1.79; p < .001). The minor discrepancy rate was higher among advanced examinations for those with concordant versus discordant subspecialty (0.34% vs 0.29%; RR, 1.17; 95% CI, 1.00-1.36; p = .04), but not different for other comparisons (p > .05). CONCLUSION. Major and minor discrepancy rates were not higher for acute community-setting examinations outside of interpreting radiologists' fellowship training. Discrepancy rates increased for advanced examinations. CLINICAL IMPACT. The findings support multispecialty radiologist practice in acute community settings. Efforts to match examination and interpreting radiologist sub-specialty may not reduce diagnostic discrepancies.

What Influences the Way Radiologists Express Themselves in Their Reports? A Quantitative Assessment Using Natural Language Processing.

Although using standardized reports is encouraged, most emergency radiological reports in France remain in free-text format that can be mined with natural language processing for epidemiological purposes, activity monitoring or data collection. These reports are obtained under various on-call conditions by radiologists with various backgrounds. Our aim was to investigate what influences the radiologists' written expressions. To do so, this retrospective multicentric study included 30,227 emergency radiological reports of computed tomography scans and magnetic resonance imaging involving exactly one body region, only with pathological findings, interpreted from 2019-09-01 to 2020-02-28 by 165 radiologists. After text pre-processing, one-word tokenization and use of dictionaries for stop words, polarity, sentiment and uncertainty, 11 variables depicting the structure and content of words and sentences in the reports were extracted and summarized to 3 principal components capturing 93.7% of the dataset variance. In multivariate analysis, the 1st principal component summarized the length and lexical diversity of the reports and was significantly influenced by the weekday, time slot, workload, number of examinations previously interpreted by the radiologist during the on-call period, type of examination, emergency level and radiologists' gender (P value range: < 0.0001-0.0029). The 2nd principal component summarized negative formulations, polarity and sentence length and was correlated with the number of examination previously interpreted by the radiologist, type of examination, emergency level, imaging modality and radiologists' experience (P value range: < 0.0001-0.0032). The last principal component summarized questioning, uncertainty and polarity and was correlated with the type of examination and emergency level (all P values < 0.0001). Thus, the length, structure and content of emergency radiological reports were significantly influenced by organizational, radiologist- and examination-related characteristics, highlighting the subjectivity and variability in the way radiologists express themselves during their clinical activity. These findings advocate for more homogeneous practices in radiological reporting and stress the need to consider these influential features when developing models based on natural language processing.

Ankle fracture management using smartphone multimedia messaging service (MMS) imaging - How reliable and to what point?

BACKGROUND: The use of smartphones and multimedia messaging service (MMS) continues to increase in day to day orthopaedic clinical practice. However, there is limited evidence to support the safe utilisation of MMS. OBJECTIVES: The aim of this study was to correlate the performance of MMS imaging to picture archiving and communication systems (PACS) imaging within the setting of diagnosis and management of ankle fractures. METHODS: The ankle fracture radiograph series of 82 consecutive patients were evaluated by five orthopaedic consultant specialists. A questionnaire regarding diagnosis and preferred management was completed separately for each patient using smartphone and PACS images. Statistical analysis was performed using Intraclass Correlation Coefficient (ICC). RESULTS: Ankle fracture diagnosis showed strong to excellent correlation both inter- and intraobserver MMS vs PACS when using the Weber (0.815, 0.988), Anatomical (0.858, 0.988), and AO classification systems (0.855, 0.985). MMS was less reliable than PACS in determining many management options. CONCLUSION: The reliability of ankle fracture classification using MMS image viewing was not significantly different to interpretation on PACS workstations. Smartphone use in ankle fracture classification is supported by this study. Smartphone use was less accurate than PACS in devising management plans and future use should be limited to making only initial plans that must be corroberated with PACS and intraoperative findings prior to definitive fixation.

Teleworking beyond teleradiology: managing radiology departments during the COVID-19 outbreak.

Teleradiology solutions are playing an essential role during the COVID-19 outbreak. Activity at radiology departments must be maintained and adapted to this new situation beyond teleradiology. Teleworking should be extended to the rest of non-medical radiology department areas. A comprehensive perspective based on our own experience during the COVID-19 outbreak has been performed highlighting the value of teleworking for almost all areas implied in the workflow of radiology departments beyond radiologists. Personal and technical requirements for successfully adapting to this new scenario are discussed including the opportunities that this unprecedent situation is bringing for reorganizing workflow and developing new projects. KEY POINTS: • Teleradiology solutions are playing an essential role during the COVID-19 outbreak. • Teleworking should be extended to the rest of non-medical radiology department areas whenever possible.

The accuracy of teleradiologists in diagnosing COVID-19 based on a French multicentric emergency cohort.

OBJECTIVES: To evaluate the accuracy of diagnoses of COVID-19 based on chest CT as well as inter-observer agreement between teleradiologists during on-call duty and senior radiologists in suspected COVID-19 patients. MATERIALS AND METHODS: From March 13, 2020, to April 14, 2020, consecutive suspected COVID-19 adult patients who underwent both an RT-PCR test and chest CT from 15 hospitals were included in this prospective study. Chest CTs were immediately interpreted by the on-call teleradiologist and were systematically blind reviewed by a senior radiologist. Readings were categorised using a five-point scale: (1) normal; (2) non-infectious findings; (3) infectious findings but not consistent with COVID-19 infection; (4) consistent with COVID-19 infection; and (5) typical appearance of COVID-19 infection. The diagnostic accuracy of chest CT and inter-observer agreement using the kappa coefficient were evaluated over the study period. RESULTS: In total, 513 patients were enrolled, of whom 244/513 (47.6%) tested positive for RT-PCR. First readings were scored 4 or 5 in 225/244 (92%) RT-PCR+ patients, and between 1 and 3 in 201/269 (74.7%) RT-PCR- patients. The data were highly consistent (weighted kappa = 0.87) and correlated with RT-PCR (p < 0.001, AUC1st-reading = 0.89, AUC2nd-reading = 0.93). The negative predictive value for scores of 4 or 5 was 0.91-0.92, and the PPV for a score of 5 was 0.89-0.96 at the first and second readings, respectively. Diagnostic accuracy was consistent over the study period, irrespective of a variable prevalence rate. CONCLUSION: Chest CT demonstrated high diagnostic accuracy with strong inter-observer agreement between on-call teleradiologists with varying degrees of experience and senior radiologists over the study period. KEY POINTS: • The accuracy of readings by on-call teleradiologists, relative to second readings by senior radiologists, demonstrated a sensitivity of 0.75-0.79, specificity of 0.92-0.97, NPV of 0.80-0.83, and PPV of 0.89-0.96, based on "typical appearance," as predictive of RT-PCR+. • Inter-observer agreement between the first reading in the emergency setting and the second reading by the senior emergency teleradiologist was excellent (weighted kappa = 0.87).

Client perceptions of the BreastScreen Australia remote radiology assessment model.

BACKGROUND: Telehealth and teleradiology are increasingly used around the world to facilitate health care provision when the health care provider and clients are separated by distance. The BreastScreen Australia Remote Radiology Assessment Model (RRAM) is an initiative developed to address the challenges of inadequate access to a local radiological workforce in regional Australia. With the growth in telehealth innovations more broadly, the RRAM represents a departure from the traditional onsite model where a radiologist would be co-located with practice staff during assessment clinics. Understanding client satisfaction is an important consideration with new models. This article explores client perceptions of the RRAM including awareness, satisfaction with experiences, confidence in the quality of care being received, and preferences regarding models of service delivery. METHODS: Clients in four BreastScreen services across three Australian states and territories were invited to provide feedback on their experiences of the RRAM. Brief face-to-face interviews based on a survey were conducted at the conclusion of assessment clinic visits. Clients also provided feedback through surveys completed and returned by post, and online. RESULTS: 144 clients completed the survey regarding their experiences of the RRAM. The majority were aged between 50 and 59 years (55/144, 38.2%). Most had attended a BreastScreen service for either screening or assessment on a total of two to five occasions (85/142, 59.9%) in the past. Nearly all women who attended a RRAM clinic expressed satisfaction with their experience (142/143, 99.3%). Clients were aware that the radiologist was working from another location (131/143, 91.6%) and the majority believed there wouldn't be any difference in the care they received between the RRAM and the onsite model (120/142, 84.5%). Clients generally had no particular preference for either the onsite or RRAM model of service delivery. CONCLUSIONS: Clients' high satisfaction with their clinic experiences, high confidence in care being received, and the majority having no preference for either the onsite or remote model indicates their acceptance of the RRAM. Client acceptance of the model supports continuation of the RRAM at these sites and expansion. Findings may inform future telehealth innovations where key health care team members are working remotely.

Emergence of teleradiology, PACS, and other radiology IT solutions in Acta Radiologica.

For this historical review, we searched a database containing all the articles published in Acta Radiologica during its 100-year history to find those on the use of information technology (IT) in radiology. After reading the full texts, we selected the presented articles according to major radiology IT domains such as teleradiology, picture archiving and communication systems, image processing, image analysis, and computer-aided diagnostics in order to describe the development as it appeared in the journal. Publications generally follow IT megatrends, but because the contents of Acta Radiologica are mainly clinically oriented, some technology achievements appear later than they do in journals discussing mainly imaging informatics topics.