Purpose
The lack of on-call radiologists,
mainly in rural areas,
the decline of French medical demography [1] and the increasing need for imaging especially in emergency cases are acute issues in care management.
Teleradiology solutions have been widely implemented,
mainly in the United States [2].
It is but an emergent practice in France where,
because of legal and cultural considerations,
teleradiology workflows as implemented overseas must be adapted,
and evaluation is still needed to validate it on a large scale [3-5].
The purpose of this study...
Methods and Materials
Our study was designed as prospective,
multicentric,
controlled and open.
It compared workflows for 6 months between two hospitals for emergency room patients undergoing CT scans read either by an on-call radiologist coming on request in one hospital or by a teleradiologist receiving requests and interpreting exams from a dedicated center in the other.
All patients were informed of the study by ER physicians and a written form.
Population
We included 478 patients undergoing CT scans,
referred by the ER physicians of two hospitals: 224...
Results
Exams
More than 50% (55.1%) of exam indications with teleradiology were represented by head trauma (29.4%) and surgical abdomen (25.7%).
More than 50% (55.8%) of exam indications with on-call radiology were represented by subarachnoid hemorrhage (19.3%),
stroke (18.9%) and head trauma (17.6%).
Surgical abdomen represented only 17.1% of exams indications with on call radiology.( Fig. 4 )
Head CT scans represented more than 50% of all exams (50.2% with teleradiology and 57.2% with on-call radiology).
Abdominal CT scans represented 27.2% of all exams with teleradiology...
Conclusion
Teleradiology does not appear to slow down emergency patient care.
Report turnaround time is overall faster,
and could improve standard of care.
Exam upload does not cause a significant delay.
Exam requisition was more often complete in teleradiology thanks to the recording of all demands and steps on a secure server and the use of mandatory items in the requisition form.
Radiation exposure was found to be slightly higher in teleradiology.
However,
this difference could be due more to different acquisition parameters on the CT...
References
La démographie médicale à l’horizon 2030 : De nouvelles projections nationales et régionales.
Ketty ATTAL-TOUBERT et Mélanie VANDERSCHELDEN,
Etudes et résultats N°679 février 2009
Teleradiology.
Part I.
History and Clinical Applications James H.
Thrall.
Radiology 2007; 243:613– 617
Guide pour le bon usage professionnel et déontologique de la téléradiologie.
Conseil Professionnel de la Radiologie (G4) ,
Conseil national de l’Ordre des médecins
Téléradiologie : champ d’action et recommandations.
JF Chateil ,
JP Masson ,
V Hazebroucq et B Silberman .
J Radiol 2006;87:1643-50
La place...
