‘Distance matters only when you fail to cover it through your mind.’
I’d love to lay claim to that saying but I’m afraid the writer Munia Khan got in ahead of me. While she may have been referring to more romantic matters, it’s a phrase that applies when you consider a successful – and sustainable – approach to teleradiology.
Technological advancements are allowing radiology services to be provided effectively remotely but how you do this without circumventing compliance and reducing quality is a huge challenge. My employers, the Royal Australian and New Zealand College of Radiologists, have devoted significant time to best utilising teleradiology to meet the growing demands for 24/7 radiologist expertise.
The seemingly inexorable rise of demand is coupled with the constraints of funding, staffing pressures, demands of government reform and regulatory change, meaning that harnessing the role of teleradiology in practices and hospitals can be a minefield. For any health organisation, though, ignoring or failing to rise to this challenge is simply not an option in 2018.
In the context of telehealth, teleradiology allows medical images to be acquired in one location and reported by a clinical radiologist in another. It can hugely benefit patients in geographically large countries like Australia or New Zealand, particularly by providing greater access to people living in remote communities or by assisting staffing at smaller hospitals that struggle to maintain out-of-hours coverage or access sub-speciality expertise.
Due to the evolving technologies and market dynamics, RANZCR realised that our previous position statements on teleradiology were no longer fit for purpose. A finessed and coherent set of its teleradiology standards were needed to guide service delivery within safe technical parameters, unambiguous clinical governance and clear lines of responsibilities, while mitigating any potential communication failures due to having specialist expertise off site.
RANZCR therefore created new standards that encapsulated established policies into 14 key principles covering issues including quality, safety, consumer interest, registration and licensing of medical practitioners, communication and record-keeping procedures. They ensure all parties understand their role in the delivery of teleradiology while ensuring that the standard of care remains uncompromised.
So what has RANZCR learnt through this journey that can help other organisations address the challenge of embracing telehealth?
Firstly, a proactive and dynamic approach is needed as telehealth expands and becomes commonplace. A problem was identified and acted upon decisively.
Secondly, by establishing key principles, RANZCR set policy parameters on key issues and ensured that service providers and staff are fully aware of their duties and responsibilities.
Thirdly, by focusing on ethics and an uncompromising stance that image quality and interpretation must not be compromised in teleradiology, RANZCR has shown that it will proactively embrace technological developments while maintaining the highest possible standards of patient care. While technology can allow patients to have access to radiologist expertise around the clock and across the country, this must not be done by cutting corners or compromising professional standards.
Harnessing the power of telehealth is a huge challenge which the health system must adapt to at a time of rising demand and constrained budgets. RANZCR has shown that by converting policy into practicable standards, technological developments can be embraced while care standards remain at the level patients expect and deserve.
Mark Nevin is Senior Executive Officer with the Faculty of Clinical Radiology and Radiation Oncology at the Royal Australian and New Zealand College of Radiologists. He will be presenting on the theme of Medical Specialists Making a Change – Fostering Sustainability in Teleradiology at the Australian Telehealth Conference on 11-12 April.
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