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What is Teleradiology and its Benefits

Keyword 1: Benefits of Teleradiology

Keyword 2 : What you need to know about Teleradiology

Keyword 3: The Basics of Teleradiology

Telemedicine is the application of information technology and telecommunications networks for the purpose of medical diagnosis and therapy from remote locations. A host of recent technology innovations have made it possible for telemedicine to expand its reach across every medical speciality– its usage in radiology is called “teleradiology.”

Radiology incorporates the diverse methods used in medical science to capture images of the internal body structure and function (eg. x-rays, MRIs, ultrasounds), to assist in the process of medical diagnosis or treatment.

Teleradiology is the capability to acquire these medical images in one location and facilitate their transmission over a range so that they can be viewed and interpreted for diagnostic or consultative purposes by a radiologist.

This practice is becoming widely adopted by hospitals, urgent care clinics, and diagnostic imaging centers. The factor responsible for its rapidly growing implementation is due to the fact that it addresses the inadequacy of appropriately skilled personnel to provide radiological analysis and the lack of practitioners of this specialty.

The process of teleradiology, in essence, is based on a fundamental triad; an image sending station, a transmission network, and a image retrieval station that should have a high-quality display screen. Additional more recent technology innovations include the incorporation of cloud for redundancy and cost reduction, mobile technologies for greater access and sophisticated teleradiology workflow that enhances radiologist productivity, provide performance metrics and track quality. .

Teleradiology improves client care by enabling radiologists to supply their expertise without necessarily being at the same location as the patient. This is especially essential when radiologist subspecialists (e.g. MRI radiologists, pediatric radiologists, neuro-radiologists) are required, because these specialists are few in number and typically located in metropolitan cities. Teleradiology therefore enhances the quality of radiology reporting by bringing the images of a patient in a small town to the most specialized radiologist who is best qualified to interpret the particular radiologic scan..

On the other hand, smaller sized healthcare facilities in rural areas might use only one radiologist or none at all. In such situations, it is virtually impossible for the radiologist to be available 24 x7 x 365. Having the support of a teleradiology reporting service can both improve the quality of life of the solo radiologist as well as improve the quality of care that might be potentially diminished by radiologist overwork..

Teleradiology can be a means through which physicians can collaborate when they are not in direct contact. For example an emergency doctor at a rural urgent care center can gain obtain a radiology consultation from a specialist urban radiologist and discuss the case telephonically while simultaneously viewing his or her patient’s images. (e.g. they are in remote places). This can be extremely valuable from the perspective of enhancing patient care and improving outcomes.

Using the services of outsourcing companies or radiology groups to supply and maintain the needed radiology coverage, smaller medical facilities are able to make better usage of their own on-site specialists and enable them to maintain their regular working hours.

This can likewise be economical for the medical facility as the outsourcing institution need only spend based on utilization, and is spared the significant fixed cost of having a radiologist on site at a small institution where they may not be fully utilized . The arrangement of these expert services to manage inpatients at small hospitals without experts on site has been revealed to be a reliable way of providing high quality care that would otherwise be unavailable.

In summary, the benefits of teleradiology are related to affording access to specialist radiologist expertise where or when none exists, to the appropriate utilization of radiologist time and energy, and to the overall enhancement of patient care, while at the same time reducing healthcare costs!

The technologies today are mature and evolved, and the outsourced model wherein images are routed to a teleradiology reporting service is an established and tested one which affords significant value, especially to small rural and community hospitals. Startup costs as well as running costs are reasonable and affordable and the process is smooth and streamlined.

 

Sounds like a pretty compelling value proposition? Try it and find out for yourself!!.

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FROM TELERADIOLOGY TO TELEPATHOLOGY: A CASE STUDY FROM RANGIA TO BANGALORE

Introduction:

Doctor shortages are acute in developing countries, where disease burden is the greatest and resources for health care are limited. An absence of pathologists in these countries has lead to delays in diagnosis and misdiagnoses that unfavorably influence patient care and survival. The introduction of telepathology into areas with specialist pathologists shortage is however one of the approaches that can be utilized to reduce the problem.

Telepathology: How it is done:

Telepathology is the electronic transmission of computerized or digital images that can be utilized for education and diagnostic consultation. The system comprises of a microscope with a mounted digital camera linked to a computer. The pathologist selects the video images for analysis and and then submits a diagnostic report.

Telepathology systems are divided into three major types: static image-based systems, real-time systems, and virtual slide systems. Static image systems have significant advantages of being the most sensibly valued and are usable in most settings; however the downside is that just the chosen subset of microscopic fields are transmitted for review by the pathologist. Real-time systems and virtual slides permit a specialist pathologist the chance to evaluate the entire specimen. With real-time systems, the specialist effectively works a microscope located at a distant site – changing focus, illumination, magnification, and field of view at will. Virtual slide systems use a robotized scanner that takes a visual image of the whole slide, which can then be sent to another area for diagnosis.

Case study: From Assam to Karnataka:

Teleradiology solutions (TRS) based in Bangalore, India provides radiology reporting services to hospitals and diagnostic centers across the world. With its team of experienced radiologists, TRS has a decade long large cumulative experience in interpreting non invasive diagnostic imaging studies including digital radiographs, CT, MRI, sonography, and nuclear medicine studies including PET-CT. With an experience of reporting for over 3 million patient studies and an understanding of technology usage in health care, TRS extended its domain to the pathology space.

Rangia is a small town in the Kamrup rural district in the Indian state of Assam. People in Rangia had no radiologist in the neighboring area to provide diagnostic assistance. A medical entrepreneur in Rangia who set up pharmacy, ultrasound, X-ray and a pathology lab approached us for teleradiology services in 2012. After 3 years of successful teleradiology and tele ECG coverage, we found that they did not have a pathologist who could interpret their hematology slides. They had to take blood samples to a pathologist at a lab located 70 kilometers away from the clinic. After hearing about this situation, using our understanding of technology for teleradiology (RADSpa), we created a solution for telepathology (PATHSpa). And proceeded to set up a new platform for Telepathology in this small town in Assam. The camera fixed on the microscope and the unit configured to the computer was the basic investment for the clinic. Hence with minimal investment, the clinic in Assam had the basic set up for a digital pathology reporting unit.

Initially technicians at Rangia had difficulty in preparing the peripheral smear and staining it. However, with training this improved. The diagnosis and reporting of the patients was quick with the help of Telerad’s pathologist. The digitally signed reports were then sent back to the clinic through the PATHSpa platform.

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AEC- Absolute Eosinophil count, CBC- Complete Blood Count, TC- Total Count, DC- Differential Count, ANC- Absolute Neutrophil Count, P.S- Peripheral Smear

A Total of 131 Telepathology reports (As shown in the figure above) were generated over a period of six months. PATHSpa was the platform used for the Telepathology service.

Challenges of rural and semi rural India:

Most of the 620 million of rural Indians lack access to basic health care facilities as 70% of total population in India is living in villages. The Indian government spends only 0.9% of the country’s yearly total domestic product on health, and little of this spending reaches remote rural areas. The poor infrastructure of rural health centers makes it difficult to retain doctors in villages, who feel that they maybe professionally and socially isolated if positioned in remote areas.

One of the solutions for this is low cost telemedicine technology coupled with robust medical service delivery. However, telemedicine activity in India has not been free of difficulties and controversies. There are certain challenges associated with the introduction of new systems and technologies. Despite the fact that the systems are easy to use, there is initial trepidation in handling computers and other digital equipment. There is a fear that the setup costs may be high and therefore monetarily not practical. In addition, there may be specialized hitches, for example, low data transfer capacity, bandwidth and electricity outages and absence of interoperability standards for software.

However, there is a significant potential for delivering medical services in rural areas of India using Telemedicine methods. At Teleradiology Solutions we developed a customized teleradiology and later a telepathology solution, which overcomes the barrier-technological as well as professional and financial-to Telemedicine. This case study demonstrates that the benefits of teleradiology can be extended to the space of pathology as well.

Pathologist view:

Dr. Seema Pavan, MBBS, MD Pathology: I am glad to be a part of Telepathology, and to help patients in Assam where diagnostic facility is not available. Here we visualize the videos sent by the clinic technician and send them the reports. The quality of the images is good, as the blood smear is of good quality which is prepared by the technicians.

Dr. Anamika Pal, MBBS, DCP Pathologist: It’s amazing to see that with the use of technology we are able to serve patients where healthcare is scarcely available. These slides and videos are as good as personally seeing slides under microscope. There are cases where Coulter gives us wrong reports and it should be verified by a pathologist. Now Telepathology makes it possible for us to reach patients even in Assam.

 

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