Is teleradiology the future of radiology?
Teleradiology has evolved from a potential threat to a more widely accepted traditional medical imaging technique and improved access to care for large numbers of patients. Many departments now use teleradiology or external reading of exams. However, there are still some obstacles to allow him to reach his full potential.
The role of teleradiology in covid-19 epidemic context
The COVID-19 pandemic reinforced the major role of teleradiology, allowing to respect health instructions and barrier gestures by exposing hospital staff much less and allowing better absorption of large volume peaks during these two epidemic waves.
The global Coronavirus pandemic has forced healthcare systems to rethink the system of patient care and many radiology practices have followed this evolution, successfully implementing offsite reading into a daily clinical workflow. This evolution is updated in a study published in the Journal of the American College of Radiology (Source: Journal of the American College of radiology - Off-Site Radiology Workflow Changes Due to the Coronavirus Disease 2019 (COVID-19) Pandemic). May 18, 2020 and this distance reading trend will only gain in importance in the years to come.
Teleradiology in clinical routine
Historically, imaging centers have delayed the use of teleradiology as part of a normal clinical workflow, but at the height of the epidemic this trend was completely reversed, and many imaging centers are now integrating this practice into the daily. This study also reveals that radiology practices have evolved and found in this technique many benefits which encourage them to continue and expand the distance care of patients, even after this epidemic.
Meeting the challenges in the medical imaging industry
Teleradiology will have to meet several major challenges to establish itself in the industrial landscape of medical imaging. When teleradiology arrived in this industry, it was very controversial, would it withdraw and concentrate essential tasks away from health centers? Was it paving the way for even greater productivity? But as its use increases, the many benefits provided have clearly been identified.
In the first place, it allows a partial response to one of the biggest current problems in France with the lack of radiologist practitioners in certain geographical areas of the territory. As a result, it allows better access to radiological examinations in areas with a shortage and thus reduces the inequality of access to care for patients living in these areas.
Teleradiology also provides great flexibility, particularly in the context of on-call duty. Carrying out examinations remotely also contributes to maintain local structures with technical platforms that interpret images remotely, sometimes for emergency care, and unify the resources of a territory to ensure the continuity and permanence of radiology care. Many other advantages can be cited such as fair access to examinations regardless of where the patient is being taken care of, a shorter time to take care of the patient, to name just a few...
Among the challenges that teleradiology must face, the question of the economic model and financing is leading, they must preserve professional independence, fair remuneration for activities as well as the sustainability of the economic model. In France, the Professional Council of French Radiology (G4) has chosen to supervise the practice by creating a dedicated ethical charter which makes it possible to disseminate good practices. This charter clearly defines the organizational objectives, the roles repartition of each stakeholder, the technical conditions essential to the performance of a teleradiology exam, as well as the remuneration and operating costs. This charter completes the legislative corpus of the public health code.
The technological component must not be neglected, it is essential in the field of teleradiology, the technical tools which are the material on the one hand and the software as well as the networks which ensure the transfer of medical images with the complementary means of communication are of paramount importance. Intrasense has an extensive portfolio of clinical applications that can be deployed and integrated into teleradiology networks. Radiologists benefit from all the tools they need wherever they are and at any time, they also have a consistent clinical workflow tailored to their needs based on the examinations performed.
In terms of organization, the involvement, animation, monitoring and adaptation to changes in practices, needs, human and material resources available must be regularly checked to sustain a teleradiology network. Permanent supervision as well as regular training and evaluation actions are essentials. Just like the participation of clinicians in the device.
Teleradiology is an activity that will mechanically develop for reasons that are largely demographic and geographic. There is no doubt that this activity will increase in the years to come. The exceptional situation we experienced this year has undoubtedly favored the use of telemedicine in general and teleradiology in particular. This period made many realize that this practice is an excellent way to ensure continuity of patient care across the country.
Perspective - Dr Cavet Madeleine, medical director of CTM groupe
Founded and managed from Montpellier by practicing radiologists, a company deeply committed to a humanist and ethical approach, CTM deploys dual expertise in the fields of digital technology and medico-organizational innovation. CGTR is the imaging branch, the leading operator in French teleradiology with more than 500,000 patients treated each year. Since 2008, it has been a pioneer in the construction of a French teleradiology, around a principle of proximity and territoriality step by step, and a rigorous management of the risks and responsibilities related to the practice in telemedicine, for healthcare teams and care facilities, for the benefit of patients.
Talking about teleradiology is like talking about telecommunications. Teleradiology today is an integral part of the radiologist profession, just as the telephone, internet and social networks are part of our communication.
As recalled by the charter of the Professional Council of French Radiology, or G4, the teletransmission of images on the technical level, or the remote interpretation on the medical level, are each only stages in the practice of teleradiology and cannot summarize the global medical act of teleradiology.
Do not confuse the “teletransmission” or “remote interpretation” of images, which is more akin to remote expertise, with teleradiology, in which the radiologist exercises his profession with full responsibility, and which requires very specific organizations and tools, in which the radiologist process his examinations, is in contact with the operator, the correspondent and the patient.
Do not confuse “remote viewing of images” with teleradiological support, the latter requiring advanced post-processing tools, standardized interpretation conditions and state of the art on certified equipment and engaging radiologist responsibility.
A radiologist, whether at the console near the operator, in the interpretation room, or in the office or hospital in which he practices, is a doctor who takes care of a patient, and this work is not limited to to interpret images. On the other hand, the G4 reminds us, this exercise is subject to the same obligations of means, safety, and quality, framed by the rules of medical ethics and good professional practices.
Well-thought-out teleradiology is an organizational method, at the service of a medical project, which guarantees safety and quality of care.
It makes it possible to guarantee access to care throughout the territory, in terms of the permanence of pooled care, for example, or reinforcement of medical resources in under-dense areas, but also equal access to excellence of this care, by allowing the exercise of a team of radiologists, multidisciplinary consultation meetings, and access to the best specialists in the area, regardless of where the patient is treated. It is by no means a goal, and must be linked to an equally efficient and qualitative organization of the clinical activities of the radiologist, ultrasound, interventional radiology, etc.
Teleradiology in the service of a medical project, supported by state-of-the-art professional digital tools, is a powerful factor in the efficiency and quality of the health system.