Emerging Challenges and Opportunities in the Evolution of Teleradiology.

OBJECTIVE. In recent decades, teleradiology has expanded considerably, and many radiology practices now engage in intraorganizational or extraorganizational teleradiology. In this era of patient primacy, optimizing patient care and care delivery is paramount. This article provides an update on recent changes, current challenges, and future opportunities centered around the ability of teleradiology to improve temporal and geographic imaging access. We review licensing and regulations and discuss teleradiology in providing services to rural areas and assisting with disaster response, including the response to the coronavirus disease (COVID-19) pandemic. CONCLUSION. Teleradiology can help increase imaging efficiency and mitigate both geographic and temporal discrepancies in imaging care. Technologic limitations and regulatory hurdles hinder the optimal practice of teleradiology, and future attention to these issues may help ensure broader patient access to high-quality imaging across the United States.

Utilidad y satisfacción respecto a una consulta virtual interniveles de patología musculoesquelética con rehabilitación / Usefulness and satisfaction regarding a virtual inter-levels consultation of musculoskeletal disorder with rehabilitation

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Estado actual de la telemedicina: ¿dónde estamos y qué nos queda por hacer? / State of the art of the telemedicine. Where are we and what is pending to be done?

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The evolution of publication hotspots in the field of telemedicine from 1962 to 2015 and differences among six countries.

Introduction Telemedicine has been implemented in many countries and has captured the attention of many researchers. Herein, we aim to quantify publication hotspots in the field of telemedicine, analyse their evolution, compare them in different countries, and provide visual representations. Methods We used software tools to process PubMed entries for a 54-year period and identified publication hotspots using keyword frequency analysis. We employed a keyword co-occurrence analysis, principal component analysis, multidimensional scaling analysis, and network visualization technology. Results The number of Medical Subject Heading (MeSH) terms increased with time. The most common subcategories of telemedicine between 1962 and 2015 were Remote Consultation, Teleradiology, and Telepathology. The most popular information communication technologies in telemedicine publications were related to the Internet and cell phones. The topics of Patient Satisfaction, Treatment Outcomes, and Home Care Services associated with telemedicine were highlighted after the 1990s. Use frequency of the terms Cell Phones and Self-Care increased drastically in the past six years, and the publication focus in six countries that had the highest output was different. Knowledge network maps and perceptual maps show the relationship between high-frequency MeSH terms. Discussion The telemedicine field has experienced significant growth and expansion in knowledge and innovation in the last 54 years. Publication hotspots for telemedicine lean towards clinical treatment, home care services, and personal care, and countries emphasize publishing in areas related to their national characteristics. This study quantitatively discusses publication hotspots, provides an objective and systematic understanding of this field, and suggests directions for future telemedicine research.

El radiólogo invisible: ¿causa o efecto? / The invisible radiologist: Cause or effect?

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Carta con relación a «El radiólogo invisible» / Letter relating to “The invisible radiologist”

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El radiólogo invisible. Respuesta de los autores / The invisible radiologist. Response of the authors

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Feasibility of using teleradiology to improve tuberculosis screening and case management in a district hospital in Malawi.

PROBLEM: Malawi has one of the world's highest rates of human immunodeficiency virus (HIV) infection (10.6%), and southern Malawi, where Thyolo district is located, bears the highest burden in the country (14.5%). Tuberculosis, common among HIV-infected people, requires radiologic diagnosis, yet Malawi has no radiologists in public service. This hinders rapid and accurate diagnosis and increases morbidity and mortality. APPROACH: Médecins Sans Frontières, in collaboration with Malawi's Ministry of Health, implemented teleradiology in Thyolo district to assist clinical staff in radiologic image interpretation and diagnosis. LOCAL SETTING: Thyolo district's 600 000 inhabitants are mostly subsistence-level or migrant farmers living in extreme poverty. Health facilities include one public hospital and 38 primary health centres. Understaffing and the absence of a radiologist make the diagnosis of tuberculosis difficult in a population where this disease affects 66% of patients with HIV infection. RELEVANT CHANGES: From September 2010-2011, 159 images (from 158 patients) were reviewed by teleradiology. Teleradiology changed patient management in 36 cases (23.5%). Two (1.3%) of them were cases of pulmonary tuberculosis not previously suspected by clinical staff. In addition, the radiologist's review corrected the misdiagnosis of tuberculosis and averted inappropriate treatment in 16 patients (10.5%). LESSONS LEARNT: Teleradiology can improve tuberculosis diagnosis and case management, especially if criteria to identify the patients most suitable for referral are developed and the radiologist is conversant with local resources and health problems. Designating a clinical focal point for teleradiology ensures sustainability. Staff need time to adapt to a new teleradiology programme.

Teleradiology.

Picture archiving and communication systems (PACS) and the Internet have changed how clinicians interact with their clinical colleagues, both during the day and at night. Teleradiology may improve the quality of life for radiologists but it also improves the quality of the interpretations for the patients. Given the opportunity this provides to connect subspecialist clinicians with subspecialist radiologists, daytime and nighttime teleradiology is likely to increase. Although teleradiology may worsen the commoditization that started with PACS, patient care will likely be improved, and that should always be the highest priority.

Hacia un uso adecuado de la telerradiología / Toward the appropriate use of teleradiology

La telerradiología no consiste en transmitir imágenes e información entre puntos distantes, sino en compartir conocimiento y trabajar en red. Facilita el acceso rápido a informes radiológicos y segundas opiniones; la teleconsulta entre médicos; la mejora de la asistencia a los pacientes; el acceso a sistemas complejos del posproceso y ayuda al diagnóstico; el apoyo a la investigación y la formación; el acercamiento de los servicios sanitarios aislados a las prestaciones continuadas o de mayor experiencia; la cobertura de 24 horas; y la promoción de la competencia entre los servicios de radiología. Los pacientes están mejor atendidos con una relación estrecha con el radiólogo. Pero la telerradiología no debe mermar la eficacia de un servicio clínico de radiología próximo al paciente. El control de los requerimientos legales, de los problemas clínico-asistenciales que puede generar y la adecuación de su uso para mejorar la salud de la población son la base de esta propuesta (AU)

Teleradiology involves much more than merely transmitting images and information between two points: teleradiology consists of sharing knowledge and working together in a network. It facilitates rapid access to radiological reports and second opinions, remote consulting among physicians, improved patient care, access to complex tools for postprocessing and computer-aided diagnosis, support for research and training projects, ties between isolated healthcare providers and busier or more experienced providers, 24-hour coverage, and competition among radiology departments. A close relation with the radiologist leads to better care. However, teleradiology should not have negative effects on the efficacy of the clinical radiology service that is closest to the patient. This article focuses on the legal requirements of teleradiology services and on the clinical problems that can arise in teleradiology settings, with the ultimate aim of ensuring the appropriate use of teleradiology to improve healthcare (AU)

Teleradiology: friend or foe? What imaging's now indispensable partner means for radiology's future and for the quality of care.

Over the past half decade, teleradiology companies have served as invaluable business partners to local radiology providers grappling with declining reimbursements, shrinking budgets, and an imaging utilization explosion that has rendered workloads unmanageable. The teleradiology business model has helped to stabilize local imaging groups through economies of scale to control costs, by facilitating rapid workflow and report turnaround times, and offering a broad range of subspecialty expertise. Teleradiology has landed radiology at an important crossroads and market forces are actively shaping its future. This article examines the role of technological innovation in teleradiology's success, and suggests that persistent technological and operational limitations raise important questions regarding quality of care. This article also joins the imaging industry's discussion as to whether radiology can be (or has been) commoditized, and explores the feasibility of the commoditization of imaging and its impact on traditional radiology practice. There appears to be an important role for teleradiology in the provision of radiology services going forward, and yet boundaries must be thoughtfully drawn in order to achieve best practices for the specialty's future. tion, commoditization.

[Teleradiology: threats and opportunities]. / Teleradiologie: bedreigingen en kansen.

Radiological interpretation and reporting have become a commodity that may be farmed out elsewhere on the planet: teleradiology. The impact of this development fully depends on our understanding of the role of radiology as a specialty. If radiology is solely defined as the provision of medical image interpretation then commoditization of radiology through teleradiology services will lead to a deterioration in the status of radiologists. They may even become redundant as hospital specialists. However, if radiology is seen in a broader context with much more emphasis on its added value through specialized consultancy, then teleradiology may be an important instrument for improvement and optimalisation of imaging services.