Dan Cinotto, our Sales & Business Development Director, was published in the March/April issue of Radiology Management! His column, The Function of Teleradiology in Modern Practice, is located on page 39 of the issue. The aim of the column is to provide insights on teleradiology utilization to radiology administrators across the country.
For AHRA and Radiology Management subscribers, you can find the column here:
https://www.radiologymanagement-digital.com/radiologymanagement/library/page/mar-apr-2024/39/
For those who would like to read it, but are not members, a full text version of the column is located below.
The Function of Teleradiology in Modern Practice
The function of teleradiology in modern day practice looks a bit different than it did five, even ten, years ago. While, at its core, it is a very simple supplement to existing workflows (covering deep overnights, weekends, and holidays), the current state is serving a much larger function that more resembles a partnership or extension of the existing radiology group than just an ‘overnight’ type service. The latter had been viewed more as an obstacle or temporary solution to a much larger problem that had no solution in sight.
In this column I will outline four things you need to familiarize yourself with to harness teleradiology’s full potential when looking at integrating teleradiology into your workflows: how to utilize teleradiology to navigate through the radiologist shortage, the impact the COVID-19 pandemic had on the teleradiology industry itself, what private equity’s role in teleradiology is, and what security enhancements are being made to address data breaches.
The first piece that we need to address is the ever-present radiologist shortage. The American College of Radiology (ACR) notes in a 2022 ACR Bulletin, ‘Of the 20,970 radiologists engaged in active patient care, 82% are age 45 and over, while 53% are age 55 and over’.[1] This is essentially telling us that the shortage is going to get worse as we move forward due to older radiologists retiring. The Radiological Society of North America (RSNA) produced figures stating that the percentage of the population over the age of 60 will double by 2050.[2] The radiologist shortage also ‘took center stage’ at RSNA 2023 conference[3], so it is clearly at the forefront of the discussion.
This paints a somewhat grim picture: an increased demand for medical imaging and fewer radiologists to read those cases. Despite this unpleasant outlook, there is good news: utilizing teleradiology services to offset the impact of these figures can help avoid radiologist burnout and improve turnaround times that can significantly impact the timeliness of critical patient care. If you need a temporary, or semi-permanent, full time equivalent (FTE) to address difficulties in physician recruitment due to the shortage, supplementing with teleradiology can certainly alleviate that stress.
The second topic that you need to be familiar with is the impact that the COVID-19 pandemic had on the teleradiology industry. As more patients found themselves in emergency departments and independent diagnostic testing facilities for chest X-rays and CTs, hospitals and radiology groups turned to teleradiology groups to help with cases that they could not accommodate in a timely fashion. This may have exposed physicians and patients to teleradiology, where they may not otherwise have been. John Kim, MD is quoted in an RSNA 2020 News Article saying, “So as staffs gets more used to teleradiology and to telemedicine in general – and it becomes more acceptable to hospitals, referring physicians, and patients – it will become more of a standard way of practicing medicine”.[4] This seems to indicate a hesitation but also seems to point to a potential lean towards adoption. Matthew Miller, the Associate Residency Program Director for Allegheny Health Network, took it step further and said “It wasn’t until the pandemic, however, many health systems were pushed to discover that telemedicine/teleradiology is not only acceptable, but in some instances, becoming the standard’.[5] If we look at this in conjunction with the radiologist shortage, the potential for teleradiology to become the standard certainly exists, even if only out of necessity.
The third thing you should familiarize yourself with is the role of private equity (PE) in the teleradiology space. This seems to be a hot button issue as it has been in the headlines quite a bit during 2023. For those not familiar with private equity groups, Investopedia defines them as: ‘investment partnerships that buy and manage companies before selling them’.[6] One could go so far to say that these groups would like to earn a profit when eventually sell them. What does this potentially mean for you and your group or site? According to Radiology Business it means that prices are going up due to the ‘private equity’s ‘voracious’ appetite for acquiring radiology groups’.[7] Not all teleradiology companies are owned/managed by these groups, but it is fair to say that the ones that are could potentially be 1.) struggling and 2.) more expensive. In a time of continual declines in reimbursement, this should be on your radar when choosing a teleradiology partner.
The final topic that we need to address, which has seen a fair amount of the spotlight in the recent past, is IT security, or more specifically – patient data breaches. According to Medical Economics, patient data breaches doubled in 2023 impacting 87 million patients in the United States.[8] This data is certainly cause for concern, especially when analyzing a potential teleradiology solution as there is a steady stream of patient data sent outside heavily protected networks and IT infrastructure.
Hours could be spent discussing the specifics on what is being done to prevent these breaches, but one of the most important things that administrators, directors, and managers can do, according to UpGuard, is to ‘manage third-party vendor risks’.[9] While most facilities will have IT and Security teams who will connect with their counterparts at the teleradiology provider, it is important as an administrator, director, or manager of radiology and imaging departments to ask some pertinent questions up front. For example, what security certifications do you have, how do you address cybersecurity threats, and what is your primary mode of data delivery? Asking these, and many other, questions up front will certainly give you an indication of how secure this potential partner really is. While the details of IT Security will almost certainly be handled by subject matter experts at your site and at the provider, you want to have a firm grip on how secure the provider is prior to connecting the appropriate parties.
What was once seen as a ‘fringe’ service that only some wanted, or needed, to utilize or a ‘break glass in case of emergency’ type of service that was necessary is now being looked at in a very different light. Teleradiology groups are being viewed as extensions of existing practices and are becoming an integral part of overall workflow efficiencies. Teleradiology, and telehealth in general, is going to grow substantially as we move forward. In fact, the teleradiology space alone is projected to grow from $2.9 billion USD in 2023 to a $10.1 billion USD space by 2033.[10] That is a 348% growth projection for the next decade. This surely points towards substantial adoption of teleradiology by healthcare providers and the increased utilization that would follow. If you are struggling with physician recruitment, have physicians who are experiencing symptoms of burnout, or just seeing volumes increased to the point where you could use an additional full time equivalent (FTE), it might be time to consider adopting teleradiology into your current practice workflow.
References
1 The Radiology Labor Shortage. The American College of Radiology. https://www.acr.org/Practice-Management-Quality-Informatics/ACR-Bulletin/Articles/March-2022/The-Radiology-Labor-Shortage. Published February 10, 2022. Accessed December 28, 2023.
2Henderson, M. Radiology Facing Global Shortage. Radiology Society of North America. https://www.rsna.org/news/2022/may/global-radiologist-shortage. Published May 10th, 2022. Accessed December 28, 2023.
3Fornell, D. 4 key trends in radiology at RSNA 2023. Radiology Business. https://radiologybusiness.com/topics/professional-associations/radiology-associations/radiological-society-north-america-rsna/4-key-trends-radiology-rsna-2023. Published December 1, 2023. Accessed December 28, 2023.
4Bassett, M. Teleradiology Soars During COVID-19 Pandemic. Radiological Society of North America. https://www.rsna.org/news/2020/april/telehealth-surge. Published April 30th, 2020. Accessed December 28, 2023.
5Miller, MJ. Current trends in radiology and how physicians and health systems plan to adapt. Health Tech Magazines. https://www.healthtechmagazines.com/current-trends-in-radiology-and-how-physicians-and-health-systems-plan-to-adapt/. Published April 17, 2023. Accessed December 28, 2023.
6Chen, J. Private Equity Explained With Examples and Ways to Invest. Investopedia. https://www.investopedia.com/terms/p/privateequity.asp. Updated March 31, 2023. Accessed December 28, 2023.
7Stempniak, M. Private equity’s ‘voracious’ acquisition of radiology practices is increasing imaging prices, study asserts. Radiology Business. https://radiologybusiness.com/topics/healthcare-management/healthcare-economics/private-equity-acquisition-radiology-practices-increase-prices. Published July 11, 2023. Accessed December 28, 2023.
8Shryock, T. Patient data breaches doubled in 2023. Medical Economics. https://www.medicaleconomics.com/view/patient-data-breaches-doubled-in-2023. Published October 23, 2023. Accessed December 28, 2023.
9Chin, K. How the Healthcare Industry Can Prevent Data Breaches. UpGuard. https://www.upguard.com/blog/healthcare-prevent-data-breaches. Updated September 3, 2023. Accessed December 28, 2023.
10Teleradiology Market Set for Remarkable Growth, Projected to Surge to USD 10.1 Billion by 2023, Fueled by Growing Healthcare Needs. Global News Wire. https://www.globenewswire.com/news-release/2023/12/12/2794940/0/en/Teleradiology-Market-Set-for-Remarkable-Growth-Projected-to-Surge-to-USD-10-1-Billion-by-2033-Fueled-by-Growing-Healthcare-Needs.html. Published December 12, 2023. Accessed December 28, 2023.