Big teleradiology firms offer to share all their secrets

When their hospital clients number in the hundreds, big teleradiology firms have to be efficient. Now two companies are making the same technologies and services that made them successful available to small fry.

At the 2006 RSNA meeting, NightHawk and Virtual Radiologic unveiled plans to make productivity tools and resources developed for in-house use available to clients.

NightHawk unveiled Talon, a version of the workflow engine that it uses to create, update, and route work lists and images to radiologists.

Virtual Radiologic introduced its Infrastructure Solutions suite, flush with the workflow technology and business operations support needed to run a teleradiology practice. It includes a workflow engine for use with RIS/PACS. It also incorporates core services that address teleradiology tasks, such as licensing and credentialing, physician scheduling, operations/call center support, HL7 integrations, and billing.

Both companies are really selling services, not technology. Those services are designed around the productivity tools and IT support that make them work well.

"Talon is software, a RIS for the teleradiology industry," said Blair Behmke, corporate sales manager for NightHawk. "When it is tied into our quality control services-into our workflow-it streamlines the process that much more."

Talon not only prioritizes studies and assigns them to radiologists for reading; it keeps track of their status, which can be followed by hospital staff from the radiologic technologist to the ER team. This keeps everyone in the loop, cuts out wasted time, and makes sure the most important studies get done first.

"This takes care of the administrative work for the radiologists," Behmke said. "It lets radiologists do what they do best: read."

Most early clients will be teleradiology practices that have their bases well covered but would like to be more efficient. Advanced Radiology is one of these.

The Baltimore teleradiology firm covers 10 hospitals in its metropolitan area with a group of about 90 radiologists, some residing well outside the company's home base, as far away as Israel.

For the past 10 years, Advanced Radiology had relied on clerical help, faxes, and "glorified Post-It" notes, according to its president, Dr. Robert Stroud, to submit and track radiology reports for its clients. That changed in mid-November when Advanced Radiology began using NightHawk's Talon system.

"Our own solution wasn't providing what we needed," he said. "We wanted to modernize the way we handle the technical component of our teleradiology service."

Within days, Advanced Radiology staff had smoothed out the bumps that inevitably come with a new process and was adept at using the Talon-based system. Talon and NightHawk were routing and load leveling across Advanced Radiology's far-flung network of readers, tracking progress on studies, and providing clients with updates.

"We can now see our turnaround time and judge our own performance, which previously had been difficult," Stroud said. "We actually see moment-to-moment workflow efficiency and the overall productivity of our docs."

NightHawk wants to build on early adopters, such as Advanced Radiology, expanding its clientele through contacts made last year before and during the RSNA meeting, where it officially launched Talon. Ditto for Virtual Radiologic, which is already in the midst of a phased rollout of its Infrastructure Solutions.

Neither company expects that providing their tools to other teleradiology firms will eat into their business. On the contrary, they expect new revenues. New clients will subscribe to the tools and the services that make them so valuable, generating a steady flow of income to NightHawk and Virtual Radiologic. This might even be augmented by more traditional forms of revenue.

Increased efficiency might lead some teleradiology companies to seek new clients, which in the near term might outstrip their own capacity. While they staff up, they might ask for help from the resource provider that led to their good fortune. They might also look for NightHawk or Virtual Radiologic to cover temporary shortfalls in coverage due to staff vacations or illness.

It would be easy to do. Subscribers' teleradiology operations would be tied into the in-house resources of NightHawk or Virtual Radiologic. It would be a relatively simple step for either firm to provide its own teleradiologists to handle cases that their clients cannot on an ad hoc short- or even long-term basis.

"We are on the same platform as our clients," said Ron Corbisier, executive director for marketing at Virtual Radiologic.

Clients buying into Virtual Radiologic will be able to access a range of individual productivity modules.

"The typical client might just leverage the workflow engine or might add the physician schedule module that allows them to intelligently coordinate or route studies to different radiologists," Corbisier said.

If they choose, however, clients can pick up an integrated suite of capabilities. NightHawk is leaning toward such a comprehensive offering, but the company will tailor its services to meet the individual needs of clients, according to Behmke.

Whether and how teleradiology firms implement these offerings could change the course of teleradiology. In the near term, at least, the general availability of proven productivity tools and resources promises to make operations that have outgrown their early processes a lot more efficient.