Technological innovations have led to new developments in the field of medicine and healthcare in general. The medical fraternity has integrated technology in its operations, leading to the development of new specialties and practices in the field. Telemedicine is such one specialty that has emanated from the integration of technology in the medical fraternity. Teleradiology is a sub-branch of telemedicine, and it involves the practice of radiology over the internet or remotely.
The purpose of this strategic plan is to outline the way Teleradiology technology can be adopted in a military facility as a cost effective measure. This strategic plan is proposed by the administrator of this military installation. Several problems identified in the operation of this facility led to the development of this plan. These included long read time cycle when making exams using radiology. After a survey was carried out, it emerged that this problem was emanating from the contract between this facility and a civilian radiologist. Further analysis revealed that the facility stands to benefit from the services of a remote radiologist.
This will save the facility more than 90,000 US dollars per year, the amount of money that is paid to the contracted civilian. Teleradiology was adopted as a solution to this problem. A MoU was signed between this facility and Aviano airbase to provide the services of a remote radiologist. Challenges such as licensure of the radiologist and incompatible Teleradiology equipment were identified. These were addressed by having the authorities at Aviano base check out the accreditations of the radiologist. Benefits of Teleradiology to the facility include reduced read cycle time and savings made.
The growth in the telecommunications sector has affected almost every aspect of the human life. ICT applications such as the internet, telephony and such others have been integrated in many aspects of human existence. Today, the mobile phone, the internet and email have become indispensable parts of contemporary societal existence.
Clinical medicine is such one aspect of societal existence that has seen an increased integration of ICT in its operations. This has led to the development of what Steinbrook (2007) refers to as telemedicine. Steinbrook (2007) defines this as the process involving the transmission of medical information and records over interactive media such as emails and telephone. The major purpose of this transmission is for consultancy and in some cases, for remote procedures, examinations and diagnosis. Telemedicine can be as simple as having a doctor call up a colleague over the phone for consultations. It can also be as sophisticated as having the doctor video conference with their colleague and sending files over the internet.
Teleradiology is one branch of telemedicine that has seen rapid developments in the recent past. According to Vandana (2003), this is the process that involves the transmission of radiological images over the net. The patient’s images are so transmitted from one locality to another for them to be interpreted by the recipient or for consultation purposes (Vandana, 2003). This includes images such as X-rays, radio scans and such others.
This report is going to look at Teleradiology as a cost effective project that can be adopted by health organizations. The author, a military hospital administrator, is going to provided evidence as to how Teleradiology can be used to run the facility efficiently by cutting on costs and by improving delivery of services. The author will analyze a problem that the military facility is currently experiencing, and then elaborate how Teleradiology can be used to address this problem.
The challenges or barriers that Teleradiology is bound to face in the organization and solutions to the same will also be highlighted. The aim of this essay is to propose a strategy that can be used to utilize the existing Teleradiology equipment and technology in this military facility to better serve the patient population. This is specifically so in reducing the amount of time it takes for an exam to process, from start to finish.
According to Betty (2000), health facilities face a myriad of problems emanating from the nature of their operations. These problems range from inefficient operations and lack of consumer satisfaction. Administrators are charged with the responsibility of ensuring that their organizations run smoothly, and as such, are required to address the various emerging challenges (Marilyn, 1996).
The case is no different in my organization, where I work as an administrator. Several challenges and problems have been encountered, problems that endanger the efficient operation of this facility. One such problem is to be found in the radiology department.
This military facility has contracted a civilian radiologist on a part time basis. This contract has turned out to be very costly and inefficient. It has led to an unnecessary increase in the time it takes to complete the “read cycle” for the diagnostic exams carried out through radiology in the facility. The “read cycle” in radiology, according to Niles (2010), is the time it takes from the taking of the radio image of the patient to the processing of the same and finally using it for a diagnosis. The process involves transcribing and interpreting the radiology image (Niles, 2010).
The current contract with the civilian radiologist is written for twelve hours of work per week. According to the contract, this civilian is required to read the exams within a 72 hours window period. It is important to note that the radiologist usually accomplishes the initial reading within the provided 72 hours.
The problem comes in after this initial read. As earlier noted, an exam read involves several processes and tasks that can be conceptualized as compartmentalized undertakings (Nieika, 2005). This is the reason why the current radiologist delays in developing the radio images delivered to them. After the initial read, the radiologist needs to transcribe and verify the same before the final report can be availed to the provider. In an ideal situation, the radiologist can take an upward of three to five days to accomplish this. All of this depends on when the exam was initiated (Bohannan, Strychacz & Meller, 2002).
The gravity of the problem is evidenced by the time it takes to accomplish the “read cycle” currently. The current read cycle takes an average of 4.9 days or 3.6 duty days to accomplish. The read cycle has a peak of 9 days and a minimum of 2 days. It is against this backdrop that the proposed strategy was developed.
The problem that is currently faced by this military facility is not unique to it. According to Steinbrook (2007), the problem can be located within the wider Air Force establishment within the United States of America. Since the year 2005, the United States Air Force has lost about fifty percent of its radiologist manpower (Steinbrook, 2007). These are lost to the private sector, especially to the research facilities that usually pay better than the United States Air Force. This development has affected the achievement of the mission of American Air Force, that of providing rapid, effective and efficient care to its beneficiaries (Norris, 2002).
Following the loss of its residence radiologist, the administrators in this facility secured a contract with a local Turkish radiologist. As earlier stated, the radiologist was to work for twelve hours in a week, and this cost the hospital 70,000 US dollars for one week.
Telemedicine and Health Care Provision in Contemporary Society
Telemedicine, as popularly believed, is not exactly a modern phenomenon. According to Holz, Handels & Buzug (2001), telemedicine, albeit in different manifestations, was to be found in early societies. For example, historians record that primitive societies will use smoke and fire signals to warn people to stay away from a village with an outbreak of contagious disease. This, in all likelihoods, can be conceptualized as a remote health care system.
With the onset of the postal services, there developed what Maheu & Whitten (2001) refer to as a care at a distance. This, according to Maheu & Whitten, was also referred to as in absentia care. This is where doctors will correspond through post, for example sending patient files via courier for consultancy services.
With the onset of the information and communication technology age, in absentia health care has evolved into what is now referred to as telemedicine (Bohannan et al, 2002).
E-health, telehealth and telemedicine are three concepts that are used interchangeably, albeit erroneously. There is a clear difference between e-health and telehealth on one hand and telemedicine on the other. Telemedicine is limited to the provision of clinical services over the internet or using any other ICT media (Hersh, Helfand, Wallace, Kraemer, Patterson, Shapiro & Greenlick (2001). Telehealth, on the other hand, encompasses the provision of both clinical and non-clinical services (Hersh et al, 2001). This is for example the provision of medical information, administrative services and consultancy services. Ehealth, especially within the context of the developed nations, is an umbrella term used to refer to a range of services. This encompasses telehealth, electronic medical files as well as other aspects of health information technology (Bohannan et al, 2002).
Types and Forms of Telemedicine
Kangerloo, Valdez, Yao, Chen, Curran & Goldman (1999) are of the view that telemedicine as a field can be divided into three major classifications. The first is store-and-forward category.
As the name implies, this is the process where patients’ medical data is collected then forwarded to a doctor or specialist at a remote location (Kangerloo et al, 1999). Data such as medical imaging and biosignals are transmitted to the specialist who then assesses the same at their own convenience. The assessment is usually done offline, way after the same had been transmitted to thee specialist. According to Bohannan et al (2002), store-and-forward telemedicine does not necessarily require the presence of both parties at the same time for the assessment of the medical data.
This is also referred to as self monitoring or testing (Roine, Ohinmaa & Hailey, 2001). This application allows medical professionals such as doctors and nurses to monitor their charges on a remote basis. This is through the use of various technological applications. Hersh et al (2001) are of the view that remote monitoring is especially used by professionals who are dealing with patients with chronic illnesses. This is for example heart conditions, diabetes and such other special conditions that call for constant contact between the care provider and the patient.
Remote monitoring, according to Kangerloo et al (1999) has several advantages over other modes of care provision such as in patient. For example, the patients derive greater satisfaction from the services given that they are able to access the health services from their home, within the loving environment of their family members. Remote monitoring is also a cost effective way of managing chronic and special conditions. For example, it is cheaper than in patient services.
There are some instances that call for a real-time interaction between the doctor and the patient (Roine et al, 2001). This is where interactive telemedicine comes in; it allows for real time interaction between the two parties. The doctor can carry on phone conversations with the patient, send emails to them or make home visits as they deem necessary. Again, this form of clinical services provision is more cost effective as compared to other conventional modes such as in patient services.
It is important to locate Teleradiology within this broad classification of telemedicine. Teleradiology can be conceptualized as being more of store-and-forward mode of telemedicine than remote monitoring or interactive medicine (Marilyn, 1996). It involves correspondence between two professional parties, and the patient is not directly involved in the exchange. The Teleradiology that is proposed for the military facility is especially a store-and-forward phenomenon. The radiology images will be forwarded to the Air Force radiologist in another military facility, who will review the images offline at their own convenience, but within the stipulated time frame.
As the name suggests, this involves the transmission of radiological images between two medical professionals in two different locations. The recipient of the images is expected to interpret, and can be viewed as a consultant for the sender.
Groen, Barry & Schaller (1998) views Teleradiology as a growing technology. This is especially so considering the fact that imaging procedures are experiencing an annual growth rate of about fifteen percent (Whitten, Mair, Haycox, May, Williams & Hellmich, 2002). This is against a rise by mere two percent within the radiologist community (Whitten et al, 2002).
One of the major benefits of Teleradiology has to do with the improvement in the quality of care that is availed to the patients. This is given the fact that the radiologist can provide care to the patient without necessarily having to be in the same location with the patient (Whitten et al, 2002). This is especially beneficial to those patients accessing care from geographically isolated locations. Teleradiology specialists are usually found in large urban areas, and as such, patients in remote areas may not be able to access their services. However, by using Teleradiology, a care provider in such a remote location can access the services of the specialists from the urban areas. Also, Teleradiology ensures that specialized services can be accessed at any time of the day, any day of the week, including weekends and holidays as necessary.
Teleradiology makes use of conventional network technologies that are in existence. This is for example the internet, whereby the two parties send messages such as emails that can contain attached files and images (Steinbrook, 2007). Teleradiology can also be conducted over the phone, whereby the two parties exchange messages over the phone. Wide area network (herein referred to as WAN) can be used to transmit the radiology images especially when the specialist is located very far away from the sourcing facility. Local are network (herein referred to as LAN) can be used in case the specialist is on the same server as the sourcing facility.
According to Bohannan et al (2002), there are specialized software and technology that is needed to facilitate Teleradiology. The scholar isolates what they refer to as the three essential components of Teleradiology. The first is an image transmitting point (Bohannan et al, 2002). This is the point from which the sourcing facility sends out the radiology images to the remote radiologist. This is the point at which the whole process of Teleradiology begins. Usually, the radiology image is scanned then uploaded via a computer onto the internet. This means that the computer at the sending station must be connected to the internet.
The second component of the Teleradiology process is a transmission network (Bohannan et al, 2002). As earlier stated, this can be WAN or LAN connectivity. Steinbrook (2007) is of the view that current internet bandwidth is large enough to accommodate Teleradiology. According to Steinbrook (2007), this means that an image reviewer is able to patch in to a remote server, and the radiologist is able to view the radiology image and make an examination. This means that it is no longer necessary for the radiologist to operate from a standard or specific workstation; they can access the images from any computer any where around the world.
This brings us to the third component of Teleradiology. This is the receiving and image viewing station (Hersh et al, 2001). This is the point where the specialist radiologist consultant receives and reviews the images and makes an exam. However, despite the fact that the images can accessed from any point on the world, it is paramount to note that the computer that the specialist uses to receive the image must be of high quality. The screen must have the right resolution to make the image clearer, and it must have undergone tests and approved for medical purposes to achieve maximum benefits. In some cases, the specialist receiving the images may connect the computer to a printer so that they can print the images and view them offline (Vandana, 2003).
The figure below shows a CT image viewed via Teleradiology:
Benefits of Teleradiology
One of the major benefits of Teleradiology, as earlier indicated, emanates from its ability to provide services at any time of the day, any day of the week and from any place, regardless of how remote it is. Communities residing in geographically isolated regions especially stand to benefit from Teleradiology services (Niles, 2010). The service has been integrated in almost all medical fields, ranging from pediatric to management of chronic conditions.
It is important to note that fields that make use of telemedicine technology are usually referred to with a “tele-(name of field)” prefix (Kangerloo et al, 1999). This is where the term “Teleradiology” emanates from, a reference of telemedicine in the radiology profession.
Teleradiology can also be beneficial by virtue of it being used as a communication channel between practitioners and specialists (Whitten et al, 2002). For example, a general practitioner located at a remote geographical location can communicate with a specialist from the urban centre or from other parts of the world. This way, as earlier stated, quality health services are availed to remote locations.
Teleradiology ensures equitable distribution of health services to the population. For example, there are areas that are not geographical isolated but still have no access to a radiologist. For example, a small hospital located in the city may be too small as to afford the services of a resident radiologist. By using Teleradiology technology, doctors and patients from this small hospital and others like it can access the services of a radiologist, leading to equitable distribution of the services.
Teleradiology also leads to efficiency in hospitals, leading to improved patient satisfaction. This is by reducing the time that is needed to make an exam through a radiology image (Roine et al, 2001). For example, without the services and technology of Teleradiology, doctors and patients in hospitals with no access to radiology services will have to wait until a radiologist makes a physical visit to the facility. This can take a lot of time, increasing the time it takes for a diagnosis to be made. However, with the use of Teleradiology, the radiology images can be analyzed and examined very fast, without the necessity of the radiologist having to visit the facility physically. It is more convenient and faster than waiting for radiology results to arrive through courier.
The cost of outsourcing radiology services through Teleradiology is cheaper than that of hiring a permanent radiologist for the facility. This efficiency is especially enhanced given the fact that the soft copy images transmitted via Teleradiology technology is as good as the image of hard copy radiology. For example, the facility can access the services of a radiologist, albeit remotely, any time of the day at a much cheaper cost (Steinbrook, 2007).
It is important to note that despite the many benefits riding on the use of Teleradiology technology, it is ambitious to imagine that it can totally substitute on-site radiologists (Hersh et al, 2001). For example, resident radiologists are required to carry out barium tests, tests that can not be carried out remotely.
One of the major roles of the administrator in any facility is to ensure that operations are smooth and efficiency is achieved. The same applies to the administrator in this military facility. This administrator will develop the proposed strategic plan that will be used to address the problem that has been highlighted above. It is their role to find a way to fix this problem.
The first step into developing a strategy is to study the problem in detail. This is the only way that the administrator will be able to identify the dynamics of the problem and the possible solutions that can be used to address it.
The proposed strategy involves having the medical facility conduct quality improvement activities that will support the goals of the quality initiative program. According to Niles (2010), it is erroneous to assume that there is a universal strategic plan that is applicable to all organizations. This is the reason why it is important to have a specific and individual strategic plan for each and every organization. This military facility employs the AAAHC 10 Elements for Performance Improvement studies model.
The purpose of carrying out this quality initiative for the organization is to make sure that the existing Teleradiology equipment and technology is efficiently used to improve the services delivered to the patients who form the clientele base for the facility. This is especially so in order to cut back on the amount of time that is spent for an exam to be processed. The goal of this strategy is to reduce this time to less than 72 hours, which is 95 percent of the time.
In the quality initiative activity proposed, only one performance goal is measurable as far as monitoring and evaluation of the strategy is concerned (Kangerloo et al, 1999). This is the “read time”, the time taken from the start to thee finish of the exam. However, there are other goals, but whose measurement is not very clear. These other goals include the savings made on the operation costs of the facility and the man hours that are saved after the implementation of the strategy. There will also be the availability of a radiologist for forty hours per week when the new strategy is finally implemented. These other goals will be discernible as soon as the memorandum of understanding is established between this facility and 31 MDG at Aviano Air Base in Italy.
The proposed plan involves outsourcing the radiology exam services, and terminating the contract of the current civilian radiologist. This is where Teleradiology comes in. it is the technology that will be used to cut down on the amount of time that is spent when reading an exam through radiology.
This being the case, the administrator needs to find a radiologist for the job, who can read the exams remotely. It is from this need that the researcher found it necessary to survey the military facilities in the area scouting for a radiologist. A clinic with a full time radiologist and equipment compatible for Teleradiology was located.
But before the administrator engages the services of a teleradiologist, it is important to track down the time that it takes to read the exam using Teleradiology and compare this with the current status. If the results are good and improvement is discernible, the services of the teleradiologist will be secured.
There is need to collect data that will be used to describe the current status of performance in the organization. Composite Health Care System data (herein referred to as CHCS) was collected (Roine et al, 2001). This is from the exam inquiry screen, and the purpose was to determine how the organization met the goals. Evidence for this data collection will be needed, and this is achieved by printing out the exam inquiry screens from the CHCS (Kangerloo et al, 1999). This will be used to determine when an exam was verified and when the radiologist verified the results of the same.
Data analysis is then needed to describe the findings and come up with frequencies, severity and source of the challenges. to achieve this, 10 random exam reports were taken from this facility’s current read process. The read cycle time of these ten exams was compared with that of 10 exam reports that were taken from the trial runs with Aviano facility. These were the exam reports conducted by Aviano between 17th and 28th August.
From the comparison conducted above, it was found that the current read cycle for this organization is about 4.9 days or 3.6 duty days. The current read cycle has a peak of nine days and a minimum of two days. The trial period, it was noted, has an average read cycle of.9 days or.6 duty days. The peak for the trial period is 4 days and a minimum of same day or zero days.
The findings of this study reveal that the time spent turning around thee films by this organization is reduced by 81.5 percent. It is 81.5 percent faster, all days included. This improves to about 83.25 percent faster when one takes into consideration duty days without factoring in the weekends.
What follows after this is the implementation of the corrective action. This is especially so given the fact that Teleradiology was found to be more efficient than the current operations of this organization.
The proposed strategy includes an establishment of a memorandum of understanding with Aviano airbase in Italy. The memorandum will outline an agreement between this organization and Incirlik to read the radiology films and to include mammography. This, according to this administrator, is expected to reduce the read time as outlined earlier. The other advantages riding on this and that will reduce the operation costs for the organization will immediately follow. This includes termination of the current radiologist contract and alleviation of the man hours needed for transcription. The facility will have the benefit of accessing the services of a radiologist 40 hours per week instead of the current 12 hours. This will reduce the operation costs of the firm. The need to credential the radiologist will also be eliminated, since this facility will not have to recruit the radiologist from the civilian. The authorities at Aviano will have already credentialed the doctor.
Benefits of Implementing the Strategy
The administrator is of the view that the use of this Teleradiology technology will bee beneficial to the organization in three ways.
Increased in Hours per Week
The current contract with the Turkish civilian dictates that the radiologist should work for duration of 12 hours per week. This means that the facility can only access these services for 12 hours in a week, creating delays in radiology exams.
The proposed MOU with Aviano air base will ensure that this facility will access the services of a radiologist for a period of 40 hours per week. This will increase the amount of time that the facility can access these services. The read time will thus be reduced, and exams will be carried out faster than before.
Reduction in Transcription Time
The doctor at Aviano air base will be using a voice dictation system to transcribe the radiology images. The Dragon Speak application will be used for this purpose. This is as opposed to the current radiologist who transcribes the images manually. This type of transcription will reduce the amount off time taken for a normal transcription by more than 20 hours per week (Steinbrook, 2007). This will lead to a same day read cycle. The doctor will be able to read, transcribe and verify the radiology image within a reasonable time, cutting back on unnecessary delays.
The current civilian radiologist under contract is very expensive. This is despite the fact that their read cycle for an exam is very long and inefficient. This is evidenced by a comparison between the performance of the trial Teleradiology with that of the current arrangement.
Conventionally, it was found that this organization, using the current radiologist to make the exam, met the goals 30 percent of the time. This is taking into consideration all days of the week, weekends and holidays included. When only the duty days were taken into consideration, the goal was met 50 percent of the time.
The efficiency of this is discernible when the performance is contrasted against that of the Teleradiology run. When exams were made remotely, 90 percent of the goal was met when taking into consideration all days of the week, weekends and holidays included. However, when only duty days were considered, the attainment of the goals improved to 100 percent.
This means that Teleradiology is more efficient than the current historical reading of exams. The reduction in the number of days taken to make a read and the number of man hours needed to transcribe means that the facility will be saving a lot of time by engaging the services of a remote radiologist through Teleradiology. The hospital will save more than 70,000 dollars per annum, the amount of money used to pay thee current civilian radiologist.
Norris (2002) is of the view that implementation of strategies in organizations is rarely a smooth undertaking. Several obstacles threaten to derail the implementation, and they must be addressed to ensure that the strategy is not compromised. The obstacles emanate from various sources from within and from without the organization (Norris, 2002). Those emanating from within the organization may include the structural organization of the firm, whereby the existing structure fails to accommodate the strategy proposed. This can be addressed by restructuring the firm or by modifying the strategy to fit in. other barriers from within the firm may be emanating from the culture and attitude of the employees. If these factors hinder the implementation of the strategy, there is need to help the employees change the same and adapt to the strategy.
Other barriers may be emanating from without the organization. These may include lack of resources to implement the strategy, including human resources. Others may be sabotage efforts from competitors in the market. All of these must be addressed for the strategy to succeed.
Barriers to Implementation of Strategy
The proposed strategy is no different from other strategies in contemporary organizations, and as such, there are challenges and barriers to its implementation. Just like in the case of other strategies as earlier discussed, the barriers to the implementation of this strategy emanate both from within and from without the organization. These challenges include the shortage of radiologists needed to implement the Teleradiology program, the credentialing process for the radiologist and the cost of the equipments. These barriers will be looked into in detail below:
Privacy Protection and Liability Issues: Legal Challenge
Nieika (2005) opines that this is perhaps the major concern for practitioners who have embraced or wish to embrace Teleradiology. This is especially so when it comes to interstate Teleradiology, where a practitioner in one state needs the services of a specialist in another state (Nieika, 2005).
The opening up of the internet space through the increased broad band raises a lot of legal and policy issues. There are questions of how the patient’s information can be transmitted over the internet without it been accessed by unauthorized third parties. The worry is that the internet is open to abuse, and as such, sending sensitive information pertaining to the health of the patient puts them at risk. Precisely, the question asked is how safe the transmission from the practitioner to the specialist is.
This challenge applies to the implementation of this strategy in this military facility. The implementation can be legally challenged by the patients or other stakeholders arguing that the information pertaining to the health of the patient is been put under threat of being accessed by third parties.
Licensure of Physicians
According to Vandana (2003), physicians in the United States of America need the approval of their state in order to practice medicine in that particular state. This includes the national exams that they have to sit before they are certified to practice in their state. This brings challenges to the adoption of Teleradiology, and in extension telemedicine, in many hospitals. The question arises; how can a specialist from another state handle the records of a patient from a different state in which they are not certified to practice?
The same issue arises in the case of the adoption of Teleradiology by this organization. This is especially so if the remote radiologist to be consulted is a civilian and as such needs licensure. The remote radiologist is also likely to be from a different state, and may not be licensed to practice within the state where this facility is located.
Lack of Compatible Technology
According to Steinbrook (2007), technology is one of the major barriers that hinder the implementation of telemedicine in organizations. This is given the fact that many organizations may be lacking in the bandwidth that is required to transmit radiology images. Some organizations may also lack in the proper equipment needed to transmit the images. This includes computers with high resolution displays and access to the internet.
A barrier to the implementation of this strategy may be the lack of compatible equipment in the remote or receiving station. This means that the receiving station may not be able to receive and process the exam.
Lack of Radiologist
After this strategy is implemented, the contract with the current radiologist will be terminated. This means that there will be no resident radiologist who can perform tests such as barium tests on the radiology images. The lack of a resident radiologist will mean that there will be no party to complement the efforts of the remote radiologist. According to Hersh et al (2001), lack of qualified radiologists or other specialists is a major hindrance to telemedicine. This is given that, to justify the amount of investment that goes into telemedicine, specialists are needed to deliver quality services.
Solutions to the Barriers
For the implementation of this strategy to succeed, there is need to address the barriers identified above. Following is a detailed description of how these barriers will be addressed:
The legal barriers, especially those to do with the protection of the patients’ information, will be addressed. The authorities of this facility will ensure that the server over which the transmission is done is secure (Steinbrook, 2007). In the memorandum of understanding with Aviano, it will be stated that the remote specialist will treat the records confidentially, and will be liable to prosecution if they disclose them to unauthorized third parties.
Licensure of Physician
This facility will circumvent the issue of licensure by having the military facility at Aviano licensure the doctor. The facility will ensure the accreditation of the radiologist is in order, and it will do this by ensuring that the radiologist is appropriately certified. Whitten et al (2002) are of the view that military facilities do not need the state by state licensure that is called for in the civilian facilities. A radiologist certified to practice in a particular military facility is equally certified to practice in other military facilities, even those outside the mother state (Maheu & Whitten, 2001). As such, the radiologist at Aviano will have no problems accessing the records and files from this military facility.
Lack of Compatible Technology
This administrator ensured that the potential outsourcing facility that will provide the remote radiologist has equipment needed to handle the Teleradiology technology. In fact, this was one of the criteria used to pick the remote station (Steinbrook, 2007). Aviano has the right equipment for this task, and this is complimented by the fact that this facility already has in existence appropriate technology and equipment for Teleradiology.
Lack of Radiologist
The impacts of this challenge will be mitigated by having access to a radiologist any time of the day, any time of the week. The MoU with Aviano states that the services of the radiologist will be accessed 40 hours per week. This is more than the current 12 hours by the civilian radiologist.
The problem in this organization was identified as a long read time cycle for radiology images. This was aggravated by the fact that the facility had contracted one civilian radiologist who works for twelve hours in a week. The radiologist is expensive, but the investment in this contract is not worth the services delivered.
A study was carried out to identify possible solutions to this problem. The study indicated that the facility stands a better chance of saving a lot of money and reducing the read time cycle by engaging the services of a remote radiologist through the adoption of Teleradiology technology. To this end, a MoU was signed between this facility and Aviano air base. The latter will be providing the services of a remote radiologist.
Several barriers that could hinder the implementation of this strategy were identified. This included legal barriers, lack of compatible technology, licensure issues and lack of resident radiologist. These were addressed by ensuring that the MoU with Aviano clearly stated that the privacy of the information accessed by the remote radiologist will be ensured. It was also verified that Aviano airbase has the right equipment for Teleradiology before the MoU was signed. The Aviano airbase will also be tasked with the tasked with the duty of verifying the credibility of the remote radiologist. This strategy proved that the facility stands to save a lot of money by adapting Teleradiology. It is a cost effective measure.
From this project, I learnt that the future of medicine is the incorporation of technology with the practice. Provision of medical services, and the quality of the same, can be improved by bridging the technological divide and integrating technology in the practice. Technology can be used as a cost effective strategy to run and operate health institutions. The experience of this project will enrich my future career experience. I will make sure that I adopt technology in my practice.
Betty, C. (2000). Telemedicine can lower costs and improve access. Healthcare Financial Management, 4(8), 30-38.
Bohannan, B., Strychacz, C., & Meller, T. (2002). Evaluation of telemedicine satisfaction among naval radiologists. San Diego: Naval Health Research Center.
Groen, P. C., Barry, J. A., & Schaller, W. J. (1998). Applying world wide web technology to the study of patients with rare diseases. Annals of Internal Medicine, 129(2), 287-309.
Hersh, W. R., Helfand, M., Wallace, J., Kraemer, Patterson, P., Shapiro, S., & Greenlick, M. (2001). Clinical outcomes resulting from telemedicine interventions: A systemic review. BMC Medical Informatics and Decision Making, 1(5), 15-27.
Holz, D., Handels, H., & Buzug, M. (2001). Telemedicine: Medicine and communication. Texas: Jones & Bartlett Learning.
Kangerloo, H., Valdez, J. A., Yao, L., Chen, S., Curran, J., & Goldman, D. (1999). Improving the quality of care through routine Teleradiology consultation. Academic Radiology, 7(3), 149-155.
Maheu, M., & Whitten, P. (2001). E-Health, telehealth and telemedicine: A guide to start-up and success. Somerset, NJ: John Wiley & Sons.
Marilyn, F. (1996). Telemedicine: A guide to assessing telecommunications for healthcare. Washington DC: Institute of Medicine.
Nieika, P. (2005). Teleradiology program evaluation. Birmingham: University of Alabama.
Niles, J. (2010). Basics of the US healthcare system. Texas: Jones & Bartlett Learning.
Norris, C. (2002). Essentials of telemedicine and telecare. Hoboken, NJ: John Wiley & Sons.
Roine, R., Ohinmaa, A., & Hailey, D. (2001). Assessing telemedicine: A systemic review of the literature. CMAJ Journal, 165(6), 765-771.
Steinbrook, R. (2007). Age of Teleradiology. The New England Journal of Medicine, 12(8), 34-38.
Vandana, S. (2003). Telemedicine gains ground in the battlefield. Annals of Internal Medicine, 6(8), 1-8.
Whitten, P. S., Mair, F. S., Haycox, A., May, R. C., Williams, T. C., & Hellmich, S. (2002). Systemic review of cost effectiveness studies of telemedicine interventions. BMJ Journal, 324(2), 1434-1437.