teleradiologyservices

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Teleradiology Proves As A Reliable, Efficient And Economically Viable Services For All Stakeholders

The discovery of Radiology by Wilhelm Roentgen, Professor of Physics at University of Wurzburg, Germany in 1895; has revolutionized the way trauma and illnesses are diagnosed and treated. Today, Radiology is not only aiding the diagnostic skills of the physician but also used for quantitative measurement of anatomic and functional processes, image-guided invasive interventional procedures, and an assessment of functional / performance of the organs.

Technology and Teleradiology:

Teleradiology integrated with advanced technology is capable of delivering rapid, reliable, real-time healthcare services without any delay/interruptions irrespective of the geographical limitations and access to specialized reporting services. The digital radiological images are compatible to be viewed on different electronic mediums (electronic monitor/display, note pads, mobile). The radiological image reaches the Radiologist’s workstation without any subsequent intervention for enhancement and review. Various software (PACS & DICOM standards) and hardware support the whole system in maintaining the quality of the image during the process (acquisition, transmission, storage, retrieval); and different compression techniques are employed to contain huge data and maintain the integrity of the digital images. Healthcare service delivery with quality, promptness, correct diagnosis, and appropriate treatment adds to the patient’s satisfaction. This whole system encompasses reliability, efficiency, and economically valued services for every stakeholder.

Reliability: The protocols, technology-based systems, and multimedia-driven communication channels have made Teleradiology one of the reliable medical services. The other contributing factors are quality of reports, access to a range of tele-reporting services (nighthawk/subspecialty / after-hour services/emergency / second opinion/weekend), experiences and expertise of the radiologists. And this reliability is intangible. It supports the referring physician or emergency department in real-time similar to on-site radiologist whereas for the centers (primary/secondary) present in rural or in geographically challenging places (for e.g., mountain terrains) it provides the physician in delivering medical care without any delay, helps the patient in deciding on transfer (trauma/emergency) or shift to a tertiary center, and encourages the efficient use of the healthcare facilities. 

Efficiency: Time is a crucial factor in patient care delivery. Teleradiology contributes to it by enabling Physician to take important decisions and delivering prompt services. It improves the Emergency department’s capacity & throughput whereas, in multispecialty tertiary hospitals, it works out as an alternate coverage for after-hours / vacation/weekends and plays important role in clearing the department’s stack. Teleradiology enhances the efficiency of healthcare centers (Secondary / Primary / Diagnostic centers) by facilitating patient care without delay, providing access to subspecialty reporting, handling postoperative complications, and reducing the readmission rates.

Economical, low-budget solutions with high value for money have been encouraging and are one of the main reasons for constant transformation and adaptation of teleradiology in line with the technology and demand in medical services. Every stakeholder, be it patient or hospital management or radiologist or treating physician gains reasonably from Teleradiology. The satisfied patient adds a competitive and winning edge to serving medical facilities.  

–     Clinically, the Physician is able to gain patient confidence and satisfaction by delivering prompt patient care with accurate diagnosis and appropriate treatment.

–     Radiologists are able to manage better work-life balance and have networked with sub-specialty radiologists.

–     Hospital management wins in multiple ways; efficiently provides medical services round the clock, handles emergency / critical cases without added costs or overheads, delivers patient care without any delay/interruption. And thereby succeed in achieving popularity with word-of-mouth promotion through satisfied patients.

–     Patients are the ultimate beneficiary of this whole system with prompt medical care which not only saves time and money but also lives. Availability of imaging reports at once provides an option to decide on many things like treatment plan/necessity to travel or shift to a specialized center, organizing fund, and emotional support.

Cloudex Radiology Solutions backs the quick TAT with reliability and efficiency…

Cloudex’s panel of qualified, experienced, and expert teleradiologists are capable of providing the interpretation of the radiological image with accuracy and profoundness in details that aid in the revelation of the underlying cause of abnormalities. Our team stands up to the statement on quality as briefed in Radiographics, 2011. 31(6): p. 1511-27 – “Quality in radiology is multi-dimensional and includes measuring, monitoring and improving various aspects of the workflow, including examination appropriateness, procedure protocol, the accuracy of interpretation, timely communication of imaging results as well as performance improvements in safety and efficiency”. We, at Cloudex work with the hospitals / diagnostic centers as a team in ensuring quality patient care from the point of entry, through scan to report delivery by involving the reporting radiologist at each stage ensuring the right protocol, adequacy, and safety of procedure while delivering the accurate interpretation within expected TAT.

Cloudex along with its reliable and efficient team delivers teleradiology services and helps its referring physician or medical facility in winning more satisfied patients as a winning edge in this competitive field.

At Cloudex, we support you to have that winning edge.

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Radiology plays an important role during the pandemic as it is essential to maintain the continuity of the health service to the patients. Using such technology based on the transmission of radiological patient images from one location to another and allows radiologists to provide services without having to be in contact with the patient is peculiarly important to minimize the expansion of the covid 19 virus.

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Today, the Web-based PACS offers many additional features like AI-Assisted Decision Support systems, Multi-Media Enhanced Reporting (MMER), an intuitive user interface, intelligent work aids (personalized tools and layout), mobile extensions, multimedia communication tools, etc that boost reading/reporting, making it a smart PACS. It is a coordinator between multiple processes (software & hardware) and applications enabling the image reporting as a real-time service supporting referring physicians.

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Cloudex Healthcare Private Limited Started in 2008 and established as a limited liability company in 2012, Cloudex is today one of the industry leaders in initiating pioneering efforts to establish teleradiology in India. and one of the award-winning startups in the state of Kerala. As an initiative by a group of clinical financial technology professionals, Cloudex aims to establish a benchmark difference in providing strategic alliances, full spectrum and responsive radiology and teleradiology solutions for tertiary care facilities, hospitals, imaging centers, clinics and patients. They expect superior quality standards at affordable prices. costs worldwide.

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Cloudex Radiology provides Online Radiology Reporting in India. Also provides Teleradiology Services worldwide in India, Africa, Nigeria, Ethiopia, Indonesia, Kenya, Tanzania, Sudan, Uganda, Chad,  Mali, Philippines, Ghana, Asia, Egypt, Libya, Middle East, South East Asia, Vietnam, Malaysia, Saudi Arabia, United States, Morocco, Mexico, Kuwait, Sri Lanka, Nepal, Italy, Bangladesh, UK, Singapore, United Arab Emirates, Ukraine, Newzealand, Afghanistan, Brazil, Russia, Ireland, etc.

Visit Us:

https://www.cloudexrad.com/teleradiology-reporting/

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How Teleradiology Can Help Early Management Of Acute Stroke

Dr. Shriram Varadharajan, Consultant Neuroradiologist (Neuroimaging & Stroke)

Awareness of stroke and immediate arrival to the hospital plays a major role in its treatment and recovery. Unlike acute coronary syndrome (ACS – heart attack) where pain plays a prominent role in patients presenting early, stroke patients ignore the negative signs such as sudden onset weakness or numbness. Often minor stroke or TIA (transient ischemic attack) serves as a warning for subsequent major stroke (CVA – cerebrovascular accident). Stroke patients need to complete timely evaluation with various imaging tools. Treatment decisions in acute stroke require ultrafast imaging. It should be performed immediately after clinical triage and emergency stabilization of the patient.

Imaging starts with the very basic question of differentiating Ischemic (clot in the vessels supplying the brain) from Hemorrhagic stroke (bleed) using a simple plain CT scan. Ischemic stroke patients may be given an injection called intravenous thrombolysis (IVT or clot lysis). Plain CT aims to exclude hemorrhage and established large infarcts which are contraindications to intravenous thrombolysis. Additional findings such as hyperdense vessel sign and ASPECTS are helpful to decide on endovascular thrombectomy. Further vascular imaging (imaging of the blood vessels – CT Angiography) is used in Ischemic stroke to detect patients with large vessel occlusion (LVO) i.e. clot inside larger blood vessels. They may need additional emergency endovascular thrombectomy (EVT or clot removal) using advanced catheter-based techniques in DSA (cath.) lab.

These treatments are currently offered to patients presenting within narrow time windows of stroke onset (3-4.5 hours for injection – IVT and 6 hours for cath. lab – EVT). CTA involves evaluating routine angiography and additional venous/delayed phases, regarding the site and presence of LVO as well as to estimate collateral status.

However, few patients who arrive late (beyond 4.5 to 6 hours and till 16-24 hours) can also be treated based on their imaging if we can identify salvageable penumbra (affected brain parenchyma but without permanent damage) using advanced imaging techniques that analyze brain parenchymal perfusion.

All of these decisions can also be taken collectively and more accurately using MRI. Ultrafast Stroke MRI takes less than 20 minutes using limited protocols and involves basic sequences as well as Angiography. MRI in acute stroke can be done without having to administer intravenous contrast and is especially very useful in differentiating from other mimics.

Parenchymal and vascular information both can be obtained. MRI involves DWI for infarct core and MRA for LVO while FLAIR mismatch can be used for IVT in stroke patients with unknown time of onset or wake-up strokes. SWI can help detect thrombus/clot burden in RBC rich clots and serve as a penumbral marker by demonstrating vessels with raised oxygen extraction.

Teleradiology can thus be very effective in acute Stroke if reporting can be accelerated to avoid time delays. Simplified reporting formats can be developed based on local logistics. Although CT and CTA are widely practiced in acute stroke, MRI provides a non-contrast one-stop solution in the emergency especially if reported immediately by dedicated, trained tele-stroke Radiologists. Structured reports for such time-based emergency situations like acute stroke help avoid medico-legal consequences especially in the era of evidence-based medicine and helps guide the referring physicians in making treatment decisions.

References

1. Varadharajan S, et al. Computed tomography angiography in acute stroke (revisiting the 4Ps of imaging). Am J Emerg Med. 2016 Feb;34(2):282-7

2. Varadharajan S. ASAP In Stroke Imaging – Need to Simplify and Standardize in Emergency. Accepted for publication in Neurology India

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Quality In Teleradiology Reporting

“Quality is the extent to which the right procedure is done in the right way at the right time, and the correct interpretation is accurately and quickly communicated to the patient and referring physician.” Hillman et al

Teleradiology is playing a crucial role in delivering patient care with its prompt and quality service.

The quality of radiological reporting depends on multiple parameters apart from the internal review and external feedback system like

Communication between the reporting radiologists and referring physician for better understanding of the case

PACS and workflow management

Operational team (CTC)

Access to reporting tele-radiologist for clarification / discussion

The Internal Parameters can be listed as –

1. Internal Quality Assurance Team sets up an auditing system involving methodology on random review of the reports and peer reviews at regular intervals. The key performance indicators (KPIs) are prepared by the team in alignment with the organization’s objective and external auditor’s standards (if involved). The experts evaluate the reporting by carrying out random double reporting, peer review, and discuss the discrepancies with reporting radiologists.

Evaluation of the discrepancies, formulation, and implementation of corrective measures followed by evaluation of implementation is a cyclic process in order to improve the quality of report and service delivery. The option of contacting the reported tele-radiologist for further clarification and discussion on prognosis is available. 

The new recruits are initially engaged in preliminary reporting for familiarization with the tele-reporting system and are supported with constant review and feedback. This also involves eLearning, teleconferencing, telemedicine, and other technological processes.

2. Procedure Protocol indicates the Right Procedure & Right Way which impacts many other parameters. The protocol includes a checklist drafted by the team on imaging procedures, image uploading/transfer, availability of support documents, defined TAT for emergency & regular cases, filled request form, to & fro communication between the referring physician and reporting radiologists, assigning of images to radiologists, etc.

3. Credentials of the tele-radiologists including the sub-specialization and experience per se augment the value of the report. In critical cases like emergency / STAT reporting, the unique skill of picking up the hidden markers in a short time plays a critical or decisive role. Their clinical focus in reporting improves referring physician’s proficiency to advise or decide on suitable investigations/management of patients. 

4. TAT is variable and crucial for referring physicians in taking control of the situation, be it for emergency or regular cases. Today, because of the technological benefits, the TAT for an emergency case is approximately less than 30 minutes whereas for any inpatient or outpatient 4 to 8 hours is maintained. Especially in teleradiology, the other factor which determines the TAT is mutual agreement between the service provider & referring center and considering cost factor as well.

5.  Miss Rate is determined by continuous reviewing of reports at regular intervals by the review panel and a lot of measures are undertaken to keep it low. The positive culture of the review panel establishes an environment that is instructive, supporting cognitive debiasing and retrospective analyses. Clients are also encouraged to report “misses” by categorizing them based on their implicating severity. Feedback and discussions with referring physicians help in the process. 

The External Parameters which can be considered are

1.  Client’s feedback system serves two purposes – understanding the quality of report and reporting services although both (service provider and referring center) would have laid down the SOPs to be followed at either end. The upload of images of other recently conducted investigations, along with other laboratory, pathology reports and previous documents like discharge summary / clinical and operational notes helps in the accurate and detailed interpretation of the images.

2.  Accreditations by the authoritative body confirms compliance with protocols set by the authority matching the industry requirement and benefitting every stakeholder. Inspections are conducted to check the protocol implementation and service delivery at regular intervals and the certification is renewed accordingly. If any discrepancy is noticed, a Plan of Correction (POC) is provided with the timeline for implementation.

Cloudex Solutions ensuring the right procedure, the right way, right time, and correct interpretation

A team comprising of qualified experts like radiologists, clinicians, and technologists who are well supported with state-of-the-art RIS PACS technology, round the clock (24 x 7 x 365) reporting services complement to the client’s advantage.  The objective of doing the right thing at right time in the right way is achieved by integrating programs to adhere to protocol, utilize the quality improvement tools, and conduct of skill up-gradation workshops.  

Cloudex brimming with experts and a wide range of tele-reporting services ensures delivery of the correct interpretation at right time in the right way; enabling the healthcare service provider to deliver quality patient care without delay and assuring proper treatment saving on time and money.

At Cloudex, we support you to have that winning edge. 

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Teleradiology Reporting Services: Do You Really Need It? This Article Will Help You

The ever-evolving medical world keeps bringing out solutions to the challenges posed by the fast pace populace. Radiology is keeping pace with modernity and has very well integrated technology and telecommunication to formulate a remote mode of extending services – Teleradiology.

Today, Teleradiology has enabled the clinician in providing the best of patient care and saving lives and thus becoming an indispensable healthcare service. Teleradiology supports the clinicians/hospitals/healthcare service providers with many solutions, compensating the shortage of radiologists and reporting for all imaging modalities – X-Ray, Ultrasound scan, CT scan, MRI Scan, PET scan, Nuclear Medicine, Interventional imaging.

1. Round-the-clock Reporting service supports the healthcare service providers with radiology services round the clock for all days irrespective of no. of radiologists on-site or subspecialty reporting requirement.

The defined reporting TAT ensures a quick TAT of as early as 30 to 60 minutes for all modalities of imaging both in cases of emergency and regular cases. In this competitive and fast-paced environment, Teleradiology enables hospitals from remotest places to small or mid-size hospitals to provide patient care effectively irrespective of time.

2. Nighthawk Reporting services works out as an ideal option for many healthcare service providers who cannot afford to recruit a radiologist beyond regular working hours and get benefitted from after-hour radiology services.

Nighthawk reporting allows the radiology department to exhibit its duty of quality reporting without any delay. This late-night radiology coverage empowers the hospitals in extending patient care to a high level with better outcomes, and in a bigger perspective improves the face-value and bottom-line score of Hospitals. 

3. Subspecialty Reporting services helps in identifying the subspecialty pathologies apart from identifying the common findings, normal variants quickly. The accuracy of reporting and detailed interpretation of the images (expertise in particular anatomy or type of reports/modality) improves the prognosis by facilitating the early diagnosis and proper treatment planning. Subspecialty reporting adds value eliminating the need for a second opinion; and improves the productivity and reporting TATs also.

Subspecialty reporting can be categorized into the following specialty –

Thoracic Imaging

Breast Imaging

Cardiac Imaging

Abdominal Imaging

Musculoskeletal Imaging

Neuroradiology

Neuro-interventional Radiology

Vascular Interventional Radiology

Emergency Radiology

Pediatric Radiology

Nuclear Medicine

4. Emergency Reporting services ensures the early intervention and initiation of required action for emergency case. The involvement of expert radiologists reduces the TAT duration and contributes to the immediate diagnosis of acute conditions and patient care.

5. Weekend / Holiday Reporting services ensure the regular radiologists are able to utilize their break productively and return to job energized without any of the radiology reporting being stalked/trailed at the health center.

6. Second Opinion Reporting service is access to expertise for getting detailed imaging reports to facilitate a better understanding of the situation or decide on the course of treatment or to understand the progression of disease or treatment outcome. Experts are able to contribute through their experience and make a value-added difference to disease management/treatment.

7. Access to Radiology by healthcare centers present at geographically challenged areas either by altitude or distance. Primary or secondary healthcare centers have benefited from teleradiology which diminished the need for on-site radiologists and have benefitted from subspecialty reporting too. This has improved patient care services through quality and timing.

Benefits of Teleradiology reporting:

· Availability of radiology services round the clock (24 x 7 x 365) including night-time and on weekends/holidays

· Access to subspecialty radiologist’s reporting

· No backlog/delay in imaging reports delivery (improved TAT)

· High-quality patient care without delay

· Reports checked by more than one radiologist (preliminary/final reads)

· Better time management of radiologists due to login enabled cloud-based system (saves on commuting)

· Software enabled workflow helps in timely delivery of reports

Cloudex Radiology Solutions offers a plethora of Teleradiology Services:

The team of experienced, expert and qualified radiologists at Cloudex’s panel extend teleradiology services encompassing all type of reporting services to fulfill the growing demand of radiology services of health providers by defying the distances and time zone. The quick TAT, accuracy, standardized report protocol, coordination network between the reporting radiologists, clinician/surgeon/technician, and administrator contributes to the delivery of services benefitting the hospital and patient.

At Cloudex, we support you to have that winning edge. 

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Cloudex radiology solutions provides affordable teleradiology reporting services.

Visit Us Now!

http://www.cloudexrad.com/teleradiology/

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Cloudex Radiology provides iHigh-Quality teleradiology reporting services. 

Visit us Now!

http://www.cloudexrad.com/