Telemedicine makes more and more of an impact on healthcare in the United States with each passing year, and teleradiology is certainly an important part of that trend. But how common is teleradiology today? Do radiologists appreciate its potential or have any concerns? A team of researchers surveyed members of the American College of Radiology in early 2019 to find out, receiving more than 900 responses.
The authors published their findings in the Journal of the American College of Radiology.
“Historically, there was concern that remote interpretation by external teleradiology providers would have potential negative consequences for the specialty as a whole in the way of commoditization, reduced reimbursement, displacement of radiology groups from their hospital contracts, increased encroachment by nonradiology specialties, and reduced quality,” wrote Andrew B. Rosenkrantz, MD, MPA, department of radiology at NYU Langone Medical Center in New York, and colleagues. “However, it also has been recognized that teleradiology can provide value by allowing broader geographic, after-hours, and multispecialty coverage, thereby achieving more robust access to rural, critical access, or other underserved populations.”
These are three key findings from the team’s survey results:
1. A majority of practices perform teleradiology
While 77.7% of respondents answered that they currently perform teleradiology at their practice, another 9.4% said they have performed teleradiology in the last decade.
And some practices only use teleradiology occasionally, but others use it constantly. Twenty-two percent of respondents estimated that teleradiology is used for at least 75% of all imaging interpretations, for instance, yet 14% of respondents only use it for 5% of all imaging interpretations or less.
“Despite historic concerns regarding the potential adverse impact of teleradiology on radiology practice, our present national survey demonstrates a critical and central role of teleradiology in modern radiology practice,” the authors wrote. “The extent to which teleradiology has become integrated into radiologists’ careers is highlighted not just by the large majority of radiologists who perform teleradiology in their practices, but also by the high percentage of radiologists’ annual imaging volumes represented by offsite interpretations, not uncommonly a majority.”
2. Bigger practices are using teleradiology more frequently
According to the team’s survey, 79.1% of radiology practices with fewer than 10 members engaged in teleradiology within the past 10 years. For groups with more than 100 members, however, that number jumps to 94.4%. Teleradiology is responsible for a majority of imaging examinations at 17.4% of the small practices with fewer than 10 members. Again, for groups with more than 100 members, that number jumps—all the way to 47.4%.
3. Radiologists see significant value in teleradiology
The survey’s questions also explored the value respondents see in teleradiology. While 89.2% perceive that teleradiology can improve geographic coverage, 82% see it as a valuable way to provide after-hours coverage to a practice’s patients. Multispecialty coverage, reductions in preliminary and final turnaround times, and coverage when a practice is understaffed are other ways that respondents believe teleradiology can demonstrate its value.
4. Challenges do remain
When asked about perceived challenges facing teleradiology implementation, the most common answer (63.5%) was consistent electronic health record access. The radiologist’s proximity to the technologist involved with each examination came in at No. 2 (48.2%) with proximity to the referring physician not far behind at No. 3 (37.6%).
“Regulatory matters such as credentialing, reimbursement, privacy, and security tended to represent lesser concerns,” the authors added.
5. Opinions are mixed on how to improve the practice of teleradiology
Respondents were asked about a variety of potential ways to improve teleradiology. None of the options necessarily ran away from the others, but technical interpretation standards was the answer that received the most support overall (30.2%). While just 9.2% of teleradiologists responded that licensing/credentialing standards could help improve teleradiology, 24.1% of respondents who aren’t teleradiologists think it could make a big impact.