In this posting I will refer to an excerpt from my interview in RT Image. Some of the questions and answers in this piece further highlight my position that "not all images are created equal." This posting specifically focuses on teleradiology as a potential option to physicians who buy their own equipment, house it in their own facility and outsource the interpretation of the images that are taken. You can read the full article by logging on to www.rt-image.com.
Teleradiology is used in two ways. Teleradiology can be an excellent resource for quality image interpretation. For instance, images performed in private offices and imaging centers that send their acquired CT or MR or conventional x-rays examinations to be interpreted by Academic Centers and sub-specialty fellowship trained Board Certified Radiologists benefit their patients. Board-certified radiologists with a specific sub-specialty, such as dedicated spine, dedicated shoulder etc., provide patients with optimal interpretation for accurate diagnosis.
Part of a good teleradiology service is also providing oversight for the acquisition of those images and assures that the images are of optimal quality. If a study cannot be interpreted because it is of suboptimal quality, the academic physicians should inform the facility in which the images were acquired.
On the other hand, private offices and imaging centers that need a radiologist to interpret the image may send their images to other countries because they need a radiologist to interpret the image in order to get reimbursed, which may offer the least expensive radiologist to provide interpretations. Most of these arrangements work on volume, so the speed of each interpretation, not the quality, is rewarded. The qualifications of the interpreting physician and their oversight of the protocols to obtain the images are questions requiring answers. Are the physicians interpreting the examination trained in America? Are they sub-specialized for the condition that they are interpreting? Some teleradiology services do screen and validate the credentials of the physician performing the interpretation but it is not required. Also , physician oversight varies with each Teleradiology site and may not be part of the teleradiology services.
As a patient, you should always ask the question -- Who is performing, reading and interpreting my imaging studies? Your physician should be working with fellowship and sub-specialty trained radiologists to help both with acquiring and interpreting the images. Collaboration between the radiologist and the clinician have the greatest potential to provide the best diagnosis and treatment decisions.www.hss.edu