TELERADIOLOGY SERVICES – THE STEADILY GROWING VOLUME OF MEDICAL IMAGING DATA

Teleradiology is a branch of telemedicine that uses telecommunication systems for the transmission of radiological images from one location to another. Additionally, it helps radiologists in interpreting various types of images, such as digitized X-rays, computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), ultrasound and nuclear medicine studies, remotely.[1] The teleradiology process generally requires three important monads, namely an image sending station, a transmission network and a receiving image station; all the aforementioned locations should further be equipped with a high-quality display screen, well-suited for clinical objectives. A computer program must also be installed at imaging stations in order to ease out the process of sending and receiving diagnostic images.[2]

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The following figure presents the types of medical image storage and transmission systems used by players engaged in the teleradiology domain.

Picture Archiving and Communication System (PACS):

PACS is a medical imaging system that is used to store, retrieve, manage, and distribute medical images. It is worth mentioning that this method eliminates the need for manual storage, retrieval, and transmission of sensitive health data of patients. Most of the PACS are connected to off-site cloud servers, which makes the storage easier and medical data accessible, essentially from anywhere around the world.[3]^, [4]

Radiological Information System (RIS):

RIS is a teleradiology software system that is used to manage data for medical images. Additionally, it can be customized to store various patient related information, such as patient scheduling, patient total radiation dose, workflow management and list management. RIS improves workflow and streamlines processes, while systems, such as PACS, provide storage and a long-term option for the management of patient information. It is worth mentioning that, both RIS and PACS act as two complementary systems which are usually used in conjugation in most of the radiology clinics.[5]^, [6]

Clinical Information System (CIS):

CIS is a computerized system that organizes, stores and validates medical information of a patient. Additionally, it maintains a record of health history, prescriptions, and doctor's notes. Further, the built-in safety features of this system minimize the chance of errors in the patient data to a large extent.[7]

Owing to numerous advantages offered by teleradiology solutions, this domain has gained a significant amount of interest from both patients, as well as radiologists. The rising interest in this domain can be attributed to following reasons:

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High Demand:

The demand for teleradiology solutions has increased manifold, over the several years. According to the American College of Radiology, the market for MRI, CT scan and interventional radiology services has increased at an average rate of 7.3% per year, during the period 2009-2021.[8] Further, post the onset of the COVID-19 pandemic, the demand for teleradiology services has increased significantly in the healthcare market.[9]

Shortage of Radiologists:

According to Charles Williams, chairman of the American College of Radiology's Commission on Human Resources, the number of new radiologists entering in this domain has increased at a rate of only 2% per year.[10] This rate is less, as compared to the rise in demand, indicating a shortage of radiologists in the current system. Experts believe that teleradiology has the potential to help overcome the challenges related to the shortage of radiologists.

Remote Reporting:

Post the onset of the COVID-19 pandemic, there has been a significant increase in the adoption rate of teleradiology solutions for the interpretation of diagnostic images. This can be attributed to the fact that patients are still reluctant to visit hospitals, owing to the COVID-19 pandemic.

Early Detection of Diseases:

Teleradiology services can help in early detection of a fatal disease. Therefore, rapid reporting becomes an extremely important factor, especially in urgent care / emergency centers, and during night hours. It is worth mentioning that reporting of such cases is made faster by outsourcing the radiology reporting to other regions, including Australia, Europe and some Asian countries (such as India).[11]

High Costs:

Currently, diagnostic imaging is considered as one of the fastest growing field. However, due to the high costs associated with conventional radiology image interpretation methodologies, teleradiology is seen as an affordable choice. This can be attributed to the fact that teleradiology solutions save travel costs (for both radiologists and patients) and expenditures of teleradiologists as they can work remotely.[12]^, [13]

The following figure presents the key benefits and limitations associated with teleradiology services.

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