Emergency radiology coverage: technical and clinical feasibility of an international teleradiology model

Abstract

The purpose of the study was to determine the feasibility of international teleradiology, utilizing day-night time differences, for online interpretation of overnight computed tomography (CT) studies. One hundred and two consecutive Emergency Room patients who underwent CT examinations between the hours of 11 pm and 7 am were enrolled. All age groups and study types were included. CT studies were transmitted from the in-hospital PACS system (Kodak, Fremont, Calif.) to a web-based server (Medweb, San Francisco, Calif.). A radiologist in Bangalore, India, working an 8 amto 4 pm day shift, downloaded and reviewed the studies on a desktop PC using a 128-kbps internet connection at 10-20:1 wavelet compression and generated a report. The report was then uploaded to the server, noting the time at upload. Each study report was compared with the official in-house diagnostic report and concordance assessed on a three-point scale. Mean download time was 8.14 s per image. For head CT reports ( n=47), the mean turnaround time for a final transcribed report was 39.5 min. For abdomen/pelvis CT reports ( n=48) the mean turnaround time was 84.4 min. Out of 106 cases, there was discordance between the clinical diagnostic report and the study report in 20 (19%); however, on subsequent review the teleradiology report was found to be correct in 13 of these. Day-night time differences across the globe can be utilized to provide overnight emergency radiology coverage using web-based teleradiology. Scan download and report upload times are within acceptable limits.

Swiss teleradiology survey: present situation and future trends

“…Teleradiology is increasingly used in the USA-for overnight coverage of imaging services. The technical feasibility of international teleradiology has been demonstrat- ed for CT cases in the USA and daily routine transmission to a satellite reading facility in India [16,17]. CT is the most important transmitted modality in teleradiology.…”

Emergency radiology without the radiologist: the forensic perspective

“…In the United States, 250,000 teleradiology interventions per year are reported (including some from overseas) [25]. The procedures in place aim to prevent the lessening of interpersonal relations, as stated by a known Yale-trained radiologist: "you can't reach over and slap [the radiologist] on the back, but every other aspect of the interaction is preserved" [26].…”

“…Negli Stati Uniti sono riportati 250000 interventi per anno di teleradiologia (anche "overseas") [25]; le procedure adottate sono tese ad evitare la rarefazione della relazione interpersonale come afferma un noto radiologo dell'università di Yale: "you can't reach over and slap [the radiologist] on the back, but every other aspect of the interaction is preserved" [26].…”

Lossy 3D JPEG2000 Compression of Abdominal CT Images in Patients with Acute Abdominal Complaints: Effect of Compression Ratio on Diagnostic Confidence and Accuracy

“…Image compression could also help radiology meet the increasing demands of medicine with regard to the time to diagnosis. The latter is evident in today's routine work and is crucial for teleradiology, particularly if teleradiology is to be used for emergency CT examinations (5).…”