Keywords:
eHealth, Radioprotection / Radiation dose, Professional issues, CT, Teleradiology, PACS, Radiation safety, Health policy and practice, Acute
Authors:
B. Rosenberg1, H. von Zanthier2, C. Rosenberg1, N. Hosten1; 1Greifswald/DE, 2Berlin/DE
DOI:
10.1594/ecr2012/C-2601
Methods and Materials
Classification and characteristics of teleradiology in Germany are reviewed.
Factual and legal positions in the context of teleradiology services are investigated for the German and the Polish side,
both in the context of European Union law.
The data analysis comprises searching relevant medical (medline) and legal (eur-lex,
juris,
beck-online,
lexis,
lex,
legalis) literature databases as well as German and Polish law and healthcare law commentaries.
The legal review focusses on ionizing radiation protection regulations and professional law.
National regulations and requirements to perform teleradiology are opposed.
Two potential binational cross-border teleradiology scenarios – “teleradiology” and “teleconsultation” - are displayed based on an anticipated medical need and characterized focussing on their potential legal and regulational impact.
The medical need in the low-populated binational region of Pomerania is anticipated based on recent statistic reports on the regional development of population,
economy and healthcare supply.
Definition of teleradiology
Teleradiology in Germany may be strictly regulated according to the German ionizing radiation protection regulation or “Röntgenverordnung” (RöV) when comprising justifying indication and remote guidance of the radiological examination as well as utilization of ionizing radiation modalities as X-ray and computed tomography (CT).
As a consequence teleradiology services in Germany are further subdivided into “teleconsultation” (= second opinion) and “teleradiology” according to the RöV(= initial reporting of findings in an examination).
Requirements for teleradiology services as defined in the German RöV (5) of 2003 are based on EU law and cover the following critical standards: 1.
Proven demand of second choice teleradiological care,
2.
Regionality of services,
3.
Justification of indication,
4.
Specified radiation protection qualification for teleradiologist and physician on site.
(see Fig.
1 + 2)
Poland in contrast only recently implemented a general definition of teleradiology as stated in the Polish ionizing radiation protection regulation.
Specific requirements for teleradiology applications other than the facility-based demands defined in the Polish Atomic Law are not postulated.