Teleradiology's Contribution to Timely Emergency Diagnoses
Need gap of emergency radiology service in India
Over the past few years, there has been a steady rise in emergency cases in India, owing to the rapid rise in our population, non-communicable diseases such as stroke and heart attacks, road accident cases, etc. For example, a survey by the World Health Organization in 2013 suggested that India accounts for 6% of the global burden of road traffic accidents. Similarly, 52% of deaths due to heart disease occur in people below 70 years of age in India. Another report published by the NITI Aayog in 2021 suggests that emergency cases account for 19-39% of all hospital admissions in various hospitals across India.
Emergency cases need prompt management to avoid death and disability and imaging plays a critical role in aiding diagnosis and guiding appropriate interventions. Emergency settings require the service of round-the-clock specialist radiologists for prompt diagnosis and management. Currently, there is a huge shortage of radiologists globally. India has only about 20,000 radiologists for a population size of about 1.4 billion. It is not uncommon for radiologists to handle both emergency cases along with routine exams which can lead to significant workload challenges. The pandemic has further highlighted a sudden rise in emergency cases can become overwhelming and lead to the failure of our existing healthcare system quickly, without a backup plan.
Role of teleradiology in Accelerating Emergency Diagnoses
Teleradiology is transforming medical imaging, allowing remote radiological interpretations for faster diagnoses and enhanced patient care. This technology eliminates distance barriers, providing 24/7 access to specialized radiologists, especially in emergencies. Teleradiology enables the transmission of medical images over long distances, improving accessibility and ensuring prompt diagnoses. It also accelerates reporting, reducing patient wait times, promoting teamwork among specialists, and bridging healthcare gaps. With ongoing developments, AI integration, and collaboration with healthcare BPO services, teleradiology's future holds improved patient outcomes and global healthcare efficiency. It enhances efficiency, scalability, and cost savings, making it a vital tool in medical diagnostics.
- Decreases report turnaround times
Several studies in the Western population have shown to improve patient care in emergency departments significantly after the adaptation of teleradiology services in their hospitals. With the availability of teleradiology services, many received the patient report on the same day within a few hours as compared to delayed reporting until the next day in the management of critical conditions.
- 24/7 coverage
External teleradiology groups provide continuous coverage for emergency room demands, benefiting patient care by avoiding unnecessary transportation, and unnecessary treatment, and improving the quality of patient care. The flexibility of teleradiology aids in managing surges of emergency cases and critically ill patients, without downfall to meet imaging demands, especially in small and medium-sized hospitals, which cannot afford on-site round-the-clock emergency radiologists.
- Timely intervention
Stroke is a leading cause of death and disability in India. Ischemic and hemorrhagic strokes, caused by blocked arteries and brain bleeding respectively, require distinct treatments. The "Golden Hour" principle underscores the importance of quick intervention, as delays lead to neuron loss. While CT scans are crucial for guiding treatment, their complexity demands swift radiologist analysis. Teleradiology and AI are pivotal in this regard. Teleradiology facilitates rapid remote analysis by radiologists, overcoming geographical barriers. Deep learning algorithms in AI, such as NeuralAssist, contribute by promptly identifying brain bleeding, analyzing tissue damage, and locating vessel blockages. These technological advancements are reshaping stroke care, leading to better patient outcomes and brain function preservation.
Similarly, the use of AI tools in teleradiology allows automatic case triaging warranting immediate attention required in patients with pneumothorax, pulmonary thromboembolism, etc.
Maxillofacial injuries, which often present in emergency settings are associated with severe morbidity and disfigurement. Their diagnosis and management on the other hand requires experienced and skilled professionals. As compared to other orthopaedic trauma, the incidence of maxillofacial injuries is quite low and can be appropriately managed in a maxillofacial trauma centre. A study carried out in the western population showed that teleradiology was being successfully to triage trauma patients from peripheral hospitals to a maxillofacial trauma hub centre for appropriate management. Following remote CT assessment, candidates were segregated based on whether they needed surgery or not for the same.
- Better Report quality
Teleradiology services generally involve reporting by experienced specialist radiologists who are trained to accurately interpret medical images in critical patients and their reporting is more focused and directed. AI tools, an integral part of teleradiology help in automatically assigning cases to the best available radiologists, depending upon their expertise and qualification. Moreover, in most cases, the reports undergo a strong peer review and quality assurance process. AI tools are being also used to incorporate standard guidelines and recommendations at all levels of patient care. This helps critical care physicians to deliver the most appropriate treatment promptly, and relevant to the emergency setting.
- Promotes collaboration among healthcare providers
Teleradiology allows both the radiologist and the emergency care physicians to view patient case reports simultaneously in real time, thereby fostering a culture of collaboration and discussion of complex cases. These communications are highly critical given that most patients in the emergency department require immediate interventions.
Emergency admissions account for a significant number of total hospital admissions in India and have a high mortality rate. When compared to other multispecialty units, the nature of cases that arrive in an emergency is diverse and often unknown, requiring a multidisciplinary approach. Emergency radiology has evolved as a subspecialty and plays a crucial role in the early diagnosis and management of emergency cases. Adopting teleradiology has been proven to be both effective, safe and cost-efficient in addressing the unique demands of an emergency department. Teleradiology can play a significant role in managing the emergency radiologist shortage in India. However, it is important to ensure that the teleradiology services adhere to quality standards and maintain patient security.
India's Teleradiology market is growing at a CAGR of 14.7%, set to reach $129 Mn in 2030 from $43 Mn in 2022. The rise is supported by increasing healthcare expenditure and digital health initiatives. Teleradiology, a subset of telemedicine, connects remote medical professionals with expert radiology services, aiding diagnosis and second opinions. The scarcity of radiologists and the need for improved access to medical imaging in remote areas drive the demand. Technological advancements and government initiatives like the National Digital Health Mission and Telemedicine Practice Guidelines 2020 are expected to further boost the teleradiology market in India.
The future of emergency teleradiologists and teleradiology groups is intrinsically tied to their ability to harness the power of AI at scale and adapt to changing workflows and roles. The agility to adopt and adapt to new technological advancements will determine the success of teleradiology practices. Radiologists, particularly those operating in a teleradiology capacity, need to evolve from being mere interpreters of images to becoming overseers of AI systems, effectively synthesizing medical information and human expertise.
The majority of teleradiology solutions incorporate applications for DICOM (Digital Imaging and Communications in Medicine) image routing. These applications enable the sharing of various medical images, including those from mammography, endoscopy, and ultrasound, among others.
Teleradiology decreases the likelihood of errors, prevents radiologist burnout, and boosts productivity, ultimately enhancing efficiency.
Teleradiology entities must establish a documented strategy for maintaining quality control, enhancement, and patient safety. These strategies should align, at the very least, with the quality protocols of both the transmitting and receiving parties and national regulations.
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