The Truth about Teleradiology

This blog post is a response to a lecture presented at the 2011 Radiological Society of North America (RSNA) meeting in Chicago. The lecture was entitled, “Outsourcing Emergency Radiology to Teleradiology Companies: The Debate Goes On.”  The presentation offered incorrect, unsupported statements about teleradiology and was based on a few anecdotal stories. I feel these blanket statements denigrated practicing teleradiologists.

Unsubstantiated criticisms were offered on several aspects of teleradiology practices, but the most offensive was the blanket statement that outsourcing leads to poor quality radiology. The unproven and incorrect claims are listed below. Since no questions from the audience were taken after the lecture, I am including my rebuttals to the inaccurate statements.

• “Teleradiologists are forced to read fast.” Almost all radiology practices make more money if they read more cases with fewer radiologists and would therefore be susceptible to the same temptations.
• “There is little or no ability to consult on difficult cases.” At vRad, our technology provides our radiologists with instant access to one, five, or 50 radiologists for help on a difficult case. In fact, it is much easier for me to consult with a subspecialist such as a neuroradiologist in my current practice environment then when I had one working in the office next door.
• “There is no access to patient charts.” vRad radiologists can obtain additional patient information with the click of a button.
• “Teleradiologists don’t protocol exams.” All protocols are set by the local radiologists and vRad radiologists are available for questions from the technologists or referring physicians 24/7/365.
• “There is little or no follow-up or oversight by a QA or risk management committee.” vRad performs millions of preliminary interpretations each year which are then over-read the next day by a local radiologist. Every single discrepancy reported by our clients is reviewed by the reading radiologist and a member of our quality assurance (QA) committee and coded by the severity of the error. Radiologists are ranked according to their QA statistics and entered into a quality improvement program when needed. In all likelihood, vRad’s QA program is more extensive, and the data is more accurate, then any other practice in this country.

These points were all included in a letter I sent to several officers of the RSNA. In addition I stated that this type of opinionated, non-scientific lecture offering one person’s condemnation of a growing, vibrant, successful, and extremely valuable component of the radiology market has no place in an esteemed scientific meeting such as RSNA.