Teleradiology European-style comes with unique risks

As teleradiology use increases in Europe, more commentators are addressing issues and limitations. One such assessment by Dr. Adrian K. Dixon of the radiology department at the University of Cambridge in the U.K. identifies a number of issues and risks.

From a European perspective, teleradiology can be problematical if the remote reader has no intimate knowledge of the medical system of the area or country where the imaging study originates.

"In the U.K., for example, the type of report would vary considerably according to whether the patient has been referred by, say, a consultant neurosurgeon rather than a primary care practitioner," Dixon said.

Dixon's January paper noted that outsourced reports should, as near as possible, be in the same style as reports customarily issued at the originating location. Otherwise, referring physicians may not understand the meaning of some reports. Also, teleradiologists should be required to demonstrate competence in the language of the country or state where the patient resides, he said (J Am Coll Radiol 2008;5(1):12-18).

"Obviously, clinicians expect reports issued in the conventional terminology of their country," Dixon said.

Standardized reporting methodology would be helpful in this regard, he said. It is extremely helpful if the remote radiologist is known to the local clinicians.

"Thus, many European healthcare systems are compiling groups or chambers of radiologists to cover a region within a country, so that there is close liaison between colleagues," he said.

Other issues with European teleradiology resemble those experienced in the U.S.

The remote reporter may not have access to all prior images for that patient and not produce a report consistent with the patient's overall clinical condition. This is particularly true as information on request forms gets briefer and briefer and assumes that the radiology department has full access to the records and previous radiological history, Dixon said.

Another fear is that outsourcing imaging studies could result in there being fewer local radiologists left to support imaging needs of the community.

"Local imaging units would be left vulnerable to the decisions of major providers, who might consider it not financially worth while keeping such units open. This could lead to a significant reduction in healthcare services to the community," Dixon said.