RIS/PACS vendor joins cross-borders teleradiology fray

Merge Healthcare has become the first U.S. RIS/PACS company to enter the fast-growing teleradiology market, offering a service that gives U.S.-based radiologists consultation interpretations provided by radiologists based in India.

Offering what Merge calls "consult prereads," the service avoids the reimbursement and credentialing difficulties posed by offshore image reading programs by having the Indian radiologists participate only as consultants and requiring a U.S.-based radiologist to review reports and give them a final approval.

The service has been tested since June at a U.S. beta site and will be offered commercially in the first quarter of next year, according to Merge officials. The company is targeting the imaging center market, which has been hit hard by reimbursement cutbacks under the federal Deficit Reduction Act and is looking for ways to streamline operations and restore profitability. Only CT and MR scans will be covered.

Images captured in the U.S. and not read by local radiologists are forwarded to a data center in Atlanta and from there to a reading facility in Pune, India. There they will be interpreted and annotated with a report prepared by one physician and reviewed by another. If they agree, the report and the annotated images will be returned to the imaging center where they originated for a signoff by a radiologist.

The Pune center is now staffed by eight physicians hired by Merge, said Robert Wells, vice president for teleradiology services. They have five to eight years of experience and some U.S. training but are not boarded.

Merge officials contend the arrangement actually amounts to a review by three sets of eyes and thus can produce superior quality. The preread can speed reviews by the U.S. radiologists, making them more efficient. Quality and efficiency data are being collected, but Merge is not yet ready to publicize them, Wells said.

Merge officials say they Indian radiologists can perform some of the more tedious tasks associated with interpretations, including tumor measurement. The information shipped to the Indian radiologists includes patient histories and relevant priors.

This is not the first time a consultant reading system has been tried. Wipro, the Indian technology giant, initiated a "collaborative reading" service in 2002 and told Diagnostic Imaging in 2003 it had performed 10,000 studies for four undisclosed U.S. customers. Wipro remains in the U.S. market but has refused to name its customers. It is likely that the service Wipro most often provides is 3D reconstruction, not image interpretation.

The RIS/PACS connection makes the Merge effort distinctive. Merge hopes that centers that use its systems see the teleradiology service as a valuable service addition.

"Where our customers are expanding into the teleradiology service business, Merge's TeleRead technology will allow our customers to leverage automation to streamline the distribution of images and relevant clinical data," said Gary Bowers, president of Merge Healthcare North America. "Radiology practices can focus on delivering teleradiology services and not on the distractions associated with the administration and labor of the teleradiology service."

Merge officials claim their service will operate seamlessly and easily at a time when traditional teleradiology companies are challenged to find a way into the final read market.

"The teleradiology services industry has been struggling with the technology to support the complex final read business," said Kenneth D. Rardin, Merge president and CEO. "Merge TeleRead supports this complex environment by providing access to current studies, prior studies, prior reports, and relevant current and historical patient information."