Integrated Teleradiology and VPACS produces new profits for rural health facilities

Sugar Land 20 October 2003As the worldwide human population migrates to urban settings, rural communities often struggle to provide basic services, such as health care. With dwindling population and resources, rural health care facilities find it increasingly difficult to compete with large urban medical centres for the treatment of patients in their own region. Radiology departments in rural facilities, where most of the profit and appeal to local physicians is centred, can now take advantage of new technology to reduce cost, improve efficiency and deliver higher earnings that translate to more effective competition.

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When your doctor decides that you need an X-Ray, ultrasound, CT or MR study to assist in diagnosis and treatment, your doctor usually refers you to a radiology department in a facility trusted to do a good job of generating and interpreting diagnostic images. This trust relationship between your doctor and the radiology department exists because your doctor has evaluated the capabilities and reliability of the facility and feels comfortable in referring you to their care.

When you arrive at the radiology department, the study is performed by a radiology technologist, a licensed specialist highly trained in operating the diagnostic equipment used in your study. Once the studies are complete, the images are delivered to a radiologist for interpretation. The radiologist is a medical doctor who specializes in reading diagnostic images, defining the problem and suggesting treatment options. After the process is complete, your doctor receives the images and a report from the radiologist that assist him in deciding on the best course of treatment.

Experts generally agree that over 50 percent of the profit generated in any health care facility comes from the radiology department, making it the most important profit centre in the facility. They also agree that the radiology department is one of the most critical aspects in marketing the capabilities of a health care facility to local doctors for patient referrals.

In the next 8 to 12 years, the health care industry will experience a severe shortage of radiologists. In Texas alone, over 50 percent of the practising radiologists are expected to retire within the next five years. Combined with falling resources, the effects of these trends could produce real hardship for many rural hospitals and clinics.

Recent technical developments have delivered answers to the special needs of rural health care facilities that will help them turn this crisis to their advantage. With a minimal investment in technology, these facilities can now offer benefits consistent with large urban medical centres at a fraction of the cost.

Teleradiology is the application of modern communications, storage and display technology to the secure transmission of medical diagnostic images. Using encrypted connections over the Internet, images can be seen by any radiologist on any computer anywhere in the world. Teleradiology provides profitable options for the health care facility and the radiologist by using an open DICOM (Digital Communications in Medicine) standard that allows different systems to freely exchange information.

For the health care facility, anyone with Internet connectivity can send studies to be interpreted, opening new income options that help to attract and retain qualified radiologists. Facilities with limited radiology coverage can expand their coverage by contracting to remote radiologists. For the radiologist, these options mean that they can now interpret studies and produce reports from any location in the world.

Picture Archival and Communications Systems (PACS) technology produces long-term storage and retrieval of diagnostic images at a cost about 20 percent of the current costs for producing and storing diagnostic films. The improved retrieval capabilities of PACS systems allow doctors to easily display older images or show the progression of conditions over time. Although this technology is obviously attractive, many smaller facilities do not have the capital and manpower to implement and maintain a local PACS system.

A more recent development, the Virtual PACS (VPACS), integrates teleradiology and PACS archival into a single system that can be utilized anywhere over the Internet. More importantly, especially for smaller hospitals and clinics, VPACS equipment can be located at a central facility and shared by many facilities. This eliminates the need for local maintenance personnel, drastically reduces the capital cost for each facility, and reduces the per study cost for archival.

Providing access to teleradiology and VPACS for local doctors eliminates the cost of delivering films and demonstrates a progressive approach to radiology that allows local doctors to display digital images directly to their patients. With reduced costs, increased efficiency, and a more personal approach to health care, smaller rural facilities can now compete directly with large urban medical centres for patient referrals by local doctors.

Lone Star Connect Enterprises is a non-profit entity in Texas that operates the Service Connect Network, providing secured Internet connectivity, basic services such as e-mail or user help desk, and enhanced services such as teleradiology, continuing education content delivery, teleconferencing, and local network maintenance and improvement. The Lone Star VPACS Teleradiology Network is the largest network of its kind dedicated to teleradiology and Virtual PACS archival services.


Leslie Versweyveld

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