Author: Telerad Tech

29 Mar 2021

Benefits of Teleradiology

Telemedicine is the application of information technology and telecommunications networks for the purpose of medical diagnosis and therapy from remote locations. A host of recent technology innovations have made it possible for telemedicine to expand its reach across every medical speciality– its usage in radiology is called “Teleradiology.”

Radiology incorporates the diverse methods used in medical science to capture images of the internal body structure and function (eg. x-rays, MRIs, ultrasounds), to assist in the process of medical diagnosis or treatment.
Teleradiology is the capability to acquire these medical images in one location and facilitate their transmission over a range so that they can be viewed and interpreted for diagnostic or consultative purposes by a radiologist.

This practice is becoming widely adopted by hospitals, urgent care clinics, and diagnostic imaging centers. The factor responsible for its rapidly growing implementation is due to the fact that it addresses the inadequacy of appropriately skilled personnel to provide radiological analysis and the lack of practitioners of this specialty.

The process of teleradiology, in essence, is based on a fundamental triad; an image sending station, a transmission network, and a image retrieval station that should have a high-quality display screen. Additional more recent technology innovations include the incorporation of cloud for redundancy and cost reduction, mobile technologies for greater access and sophisticated teleradiology workflow that enhances radiologist productivity, provide performance metrics and track quality. .

Teleradiology improves client care by enabling radiologists to supply their expertise without necessarily being at the same location as the patient. This is especially essential when radiologist subspecialists (e.g. MRI radiologists, pediatric radiologists, neuro-radiologists) are required, because these specialists are few in number and typically located in metropolitan cities. Teleradiology therefore enhances the quality of radiology reporting by bringing the images of a patient in a small town to the most specialized radiologist who is best qualified to interpret the particular radiologic scan..

On the other hand, smaller sized healthcare facilities in rural areas might use only one radiologist or none at all. In such situations, it is virtually impossible for the radiologist to be available 24 x7 x 365. Having the support of a teleradiology reporting service can both improve the quality of life of the solo radiologist as well as improve the quality of care that might be potentially diminished by radiologist overwork..

Teleradiology can be a means through which physicians can collaborate when they are not in direct contact. For example an emergency doctor at a rural urgent care center can gain obtain a radiology consultation from a specialist urban radiologist and discuss the case telephonically while simultaneously viewing his or her patient’s images. (e.g. they are in remote places). This can be extremely valuable from the perspective of enhancing patient care and improving outcomes.

Using the services of outsourcing companies or radiology groups to supply and maintain the needed radiology coverage, smaller medical facilities are able to make better usage of their own on-site specialists and enable them to maintain their regular working hours.

This can likewise be economical for the medical facility as the outsourcing institution need only spend based on utilization, and is spared the significant fixed cost of having a radiologist on site at a small institution where they may not be fully utilized . The arrangement of these expert services to manage inpatients at small hospitals without experts on site has been revealed to be a reliable way of providing high quality care that would otherwise be unavailable.

In summary, the benefits of teleradiology are related to affording access to specialist radiologist expertise where or when none exists, to the appropriate utilization of radiologist time and energy, and to the overall enhancement of patient care, while at the same time reducing healthcare costs!

The technologies today are mature and evolved, and the outsourced model wherein images are routed to a teleradiology reporting service is an established and tested one which affords significant value, especially to small rural and community hospitals. Startup costs, as well as running costs, are reasonable and affordable and the process is smooth and streamlined.

Sounds like a pretty compelling value proposition? Try it and find out for yourself!!.

15 Mar 2021

Pneumothorax Detection and Classification on Chest Radiographs using Artificial Intelligence

Pneumothorax Detection and Classification on Chest Radiographs using Artificial Intelligence

A pneumothorax is an abnormal collection of air in the pleural space between the lung and the chest wall. This air pushes on the outside of the lung, causing it to collapse. A pneumothorax can be caused by a blunt or penetrating chest injury, certain medical procedures, or from underlying lung disease, typically emphysema. Depending on its size, pneumothorax can result in complete lung collapse or collapse of only a portion of the lung. Occasionally it may occur for no obvious reason (idiopathic). Pneumothorax can potentially be life-threatening and is considered to represent a critical finding in Emergency Radiology (ER), requiring immediate reporting to the treating physician to ensure immediate medical attention. Hence, Pneumothorax detection is of critical importance in clinical care. Pneumothorax may be detected with the help of image processing and deep learning algorithms. If utilized effectively, deep learning techniques can assist radiologists with quick detection, segmentation, classification and quantification of pneumothorax. In this paper, we evaluate two deep learning architectures for the detection and segmentation of pneumothorax regions on chest radiograph images. The AI system detects regions of pneumothorax in a chest radiograph and may assist the radiologist to review on priority the cases that contain a pneumothorax and thus facilitate early management of patients.

06 Nov 2020

Enhancing RIS-PACS solution with Artificial Intelligence

It has become fairly clear of late that using technologies is aiding radiologists in not just enhancing patient care but also optimizing their time and effort. Several universities across the globe including the University of Virginia Health System are now looking for platforms that can be seamlessly integrated with Radiology Information System (RIS) and Picture Archival Communication System (PACS) to help not just streamline the workflow but also help detect findings that could be missed manually.

For instance, with the help of Artificial Intelligence (AI), loss in bone density can be found out at an early stage. There are probabilities of missing these detections while using the traditional interpretation method. Some AI Software uses colors to denote normal and abnormal findings. This speeds up the reading workflows in the PACS. Also, this is perfect for radiologists because then they know which results need his/her urgent attention. With AI software assisting in findings ranging from chest, pelvis CT scans and abdomen, coronary calcium, liver steatosis, pulmonary emphysema, spine compression fractures and bone mineral density, healthcare is all set to get transformed and how.

Preventive Care

An exciting step in preventive care, AI enhances RIS-PACS even as it leads to early detection of various conditions as well as ailments. It is but obvious that artificial intelligence is playing a key and an extremely vital role that could also go beyond regular readings and avert serious diseases from developing.

Sophisticated AI algorithms can now go hand-in-hand with RIS-PACS and deliver the added benefit of expediting the reading process while at the same time identifying findings that may go unobserved or are hard to visualize.

Enhanced Workflow

AI software can be running in the background and putting forth clinically significant and relevant findings that could have been missed.

Some software are developed with an access to in-house AI algorithms which integrates seamlessly with its RIS-PACS. This makes it convenient to easily integrate it with the workflow and give a unified AI experience to the user. These AI tools, when executed over the scanned images, empowers Radiologists to provide increased, consistently accurate and faster diagnosis.

Even in the sphere of Veterinary Sciences, AI helps with the workflow and enables integrated image management through central­ized scheduling to multiple connecting modalities, sites or centers. 

Automation Benefits

Automation is key for many AI tools and many radiologists prefer to call it the perfect assistant technology. Many AI software take on duties that make a radiologist’s job easier. When the radiologists are overburdened with studies, they tend to be in a rush and this in turn increases the error rates. AI puts together machine and humans and makes this combination much more powerful and error free.

Enhancing RIS-PACS, AI software works in tandem to lay emphasis and focus on high quality radiology reporting and accessibility. Deploying AI for radiology will only add immense value to patient diagnosis and care.

13 Oct 2020
Transforming Radiology Technology

The Transformation of Radiology using Technology

Radiology has indeed come a long way since 1895, the year of the spectacular discovery of X-rays by German physicist Wilhelm Roentgen. It now plays an inherently crucial role in improved and better diagnosis and patient care.

The past few decades have seen the limits of imaging informatics being pushed beyond traditional boundaries thanks to several major changes in computer and communication technology. With the advent of new technologies, such as the World Wide Web, wireless connectivity, and, now, the ever-present social networks, momentous advancement has been made in the way radiological services can be delivered. The Internet has become a crucial gateway for electronic transmission and sharing of health-related data, something we today know as “e-Health”. Many types of e-Health are currently becoming available. In many hospitals, the electronic health record (EHR) is being introduced, which allows a complete electronic record of the patient’s health information. This EHR should not only automate and streamline the physician’s workflow but also allow patients to gain control over their health data through online portals.

The move from an analog to a digital working milieu put the radiologists at the front line of producing and distributing digital images. New dedicated software products were developed. One of the most important shifts being adopted by many healthcare institutions across the globe is a paper-free environment and the Picture Archive and Communication System (PACS) and Radiology Information System (RIS). These are truly remarkable steps in this direction. Radiologists employ the PACS to store myriads of image files which can be easily retrieved at any time in the patient management. Making lives extremely convenient, the entire database of images of all patients across all modalities is just a click away. It not just saves time but with the help of software solutions like RIS, it is now possible to keep a track record of every patient from scheduling appointments to diagnosis and treatment.

Transformative new technologies, many powered by cloud-based RIS-PACS, Artificial Intelligence (AI) and machine learning, promise to redefine the practice of radiology in ways that will considerably improve productivity, diagnostic quality, and medical treatment. Today, cloud-based computing in the imaging market has evolved from a service that provided cost-effective disaster recovery for archived data to fully featured PACS. It’s vendor neutral archiving services can address the needs of healthcare providers of all sizes, on the go.

Taking a look at AI, we need to identify AI’s strengths in analyzing visual images. Researchers train the algorithms to better detect potentially dangerous abnormalities, generating faster and more accurate insights to help guide clinicians’ treatment decisions. AI adoption is sure to ease the overwhelming workloads impeding the profession, facilitating radiologists to do what they’re best at and perform them better.

Going further ahead, we can examine Workflow orchestration technology too. This promises to boost efficiency and alleviate bottlenecks. By directing cases to the right recipient in the correct order, this technology optimizes the effectiveness of the read, especially in teleradiology settings. With the profession’s ever-increasing need for solutions that match demand with supply, a lot of organizations provide solutions that facilitate better collaboration across facilities for effective workflow orchestration.

Teleradiology is another field that is assisting well where streamlining workloads is concerned. Remote radiologic coverage and reliable telecom infrastructures means more radiologic analysis is being performed online to take care of workloads between hospitals. And as the field becomes progressively digitized, apprehensions regarding the security of radiology data accentuate the need for robust solutions that will not just prevent breaches but at the same time also safeguard patient information while complying with regulatory requirements.

Diagnostic images captured at the right place and at the right time give physicians, surgeons, and care centers an important tool to help provide better patient care and at a reasonable cost. For this reason, Telerad Tech has been building out solutions since 2009.

Telerad Tech was established with the goal of optimizing radiology productivity and improving patient outcome delivery through transformational medical imaging software solutions. Today, it is amongst the market leaders in providing integrated RIS-PACS software solutions for teleradiology, medical imaging centres, and hospitals of all sizes globally. Telerad Tech’s solutions cater to workflows needs across departments, including Radiology, Cardiology, Podiatry, Orthopedic, Chiropractic, Oncology and Veterinary.

We are today amongst the market leaders in providing RIS with integrated PACS with significant installations in both cloud and enterprise environment across 1500 facilities in 24 countries.

Our software solutions suite has been incubated, tested and perfected in a radiology ecosystem and are designed to address the unique needs of multiple care pathways across departments, including radiology, cardiology, dentistry, oncology, and veterinary. Our software has customizable workflow features, intelligent productivity tools & analytics and Vendor-Neutral Archive technology. It has strong patient security framework and integrates seamlessly with other systems for exchange and retrieval of electronic health information.

To enable physicians to consistently deliver optimal patient management and to augment the precious time of radiologists, Telerad Tech has also leveraged Artificial Intelligence (AI), for various radiology diagnostics.

We truly believe that the future is here

Technological development has undoubtedly prompted some anxiety among radiologists. But while tech adoption will inevitably alter the way radiologists work, technology’s clinical value will be in supplementing and adding to and not replacing or even displacing the professionals. Radiologists empowered by AI will only encounter a new, more efficient stage of radiology, helping to focus their time and attention on the most crucial elements of their job.

Also, we need to remember that image analysis is just one of the aspects of a radiologist’s job, other tasks, including discrepancy reviews, diagnostic reasoning, and patient-facing work such as invasive radiology, will still be performed by humans. Those tasks will simply be supported and enhanced by advancing technology.

The future of radiology is here, and the prediction clearly states that it will not only better health care but also the lives of all the stakeholders.

24 Sep 2020

What do you look for in a RIS/PACS for a Tele-radiology application

Let’s face it. Today a PACS is a commodity …has been for quite a while.
Most PACS and for that matter RIS on the market can do most everything………..at least that is what the brochures claim!

For a Tele-radiology application, these are some of the important requirements

  • What are the workflow features it supports?
  •  How easy is it for a Radiologist to set up a practice for himself or herself?
  •  How many reports can the Radiologist dictate in a day?
  •  What is the cost of ownership?

Let’s take the last one first!

Today, reducing reimbursements from insurance companies, increasing competition across the globe, and the need to provide quality care in spite of all the above – are forcing owners of imaging centers to question the cost of ownership.

This is where the cloud-based solution brings value to the table. With a cloud-based solution, the vendor is responsible for the high end redundant servers housed in class III or similar data center, disaster management solutions, archiving studies and reports for 7 years or more. This solution provides a very low or practically nil cost of ownership.

The Radiologist or the owner can focus on building the business, signing up new hospitals, and bringing the bacon home! The cloud based solution gives him a lot more flexibility and freedom to go after new prospects even if they are not in the same state or even the same country.

The number of reports a Radiologist can generate in a day translates to profits. The system must be simple to use and the reporting engine and viewer must allow him to dictate as quickly as possible. Interface with a Voice recognition system, easy content (text and audio) exchange between the Radiologist and transcriptionist, peer review with ABR codes, QA, real time collaboration between different stakeholders are some of the features to look for in a system. The Radiologist must be the last link in the chain and studies/images must reach him only when they are complete in all respects, thereby saving his valuable time. Some systems have the reconciliation feature that handles this part of the assignment. The system must support all DICOM modalities which can be added any time later with ease and also support non DICOM for use with legacy modalities.

The system must be simple to use and more importantly easy to install. The Radiologist must be able to start his business or add a new hospital within hours thereby generating confidence in his business. If the hospital or clinic that is sending studies provides a VPN -then the issue of encrypting, security, and safe transmission are taken care of and there is no need for any hardware purchase by the Radiologist. If not, a simple PC that can house the DICOM router software and route the studies fast and efficiently to the central server, is sufficient. The system must also be universal such that it should not need any proprietary hardware for viewing and should be able to log in from any browser. Viewing and distributing images on a mobile device is becoming ubiquitous today and helps the Radiologist to take instant decisions from an airport or a coffee shop!

Last but not least the workflow features are very important. It is indeed an irony that when you mention workflow, most people have the “deer caught in the headlights look”. The workflow is the most important factor which contributes to the productivity and thereby to the bottom line of the enterprise. Some systems provide a “soup to nuts” solution for the workflow from capture to archive while some provide certain modules. Here it is important to get a standard off-the-shelf software that can be customized -rather than develop one from scratch and make it proprietary, finding it difficult to change in the future. The workflow defines many conditions that improve overall efficiency.

For example:

  • Assignment of studies to a Radiologist depending upon various conditions
  • Workflow parameters like TAT, number of reads, work load, QA score for Radiologist
  • Auto assignment or through manual intervention by an Administrator
  • Monitoring TAT (Turn Around Time) and reassigning studies if TAT is not met
  • Collaboration between various stakeholders through work-list
  • Customizable work-list which enables the user to see what they want to see and hide the extraneous information.
  • Monitoring QA, reconciliation, Peer review to help improve the quality of care to the patient
  • Integration with existing front end or back end solutions using HL7 or web links
  • Accessing PRIORS and showing patient demographics to the Radiologist while reporting to enable faster and more accurate reporting
  • Enabling the patient to get hold of the report and studies through a secure patient portal.
  • Use of mobile devices and maybe a QR code to make it easy for the patient to receive the information.

These are just some of the important workflow features to look for. It is best to ask the vendor what they provide – to help you improve the productivity of the Tele-radiology center. An important characteristic the software should provide is the flexibility to customize the features to get the best bang for your buck.

Many vendors who are in this business should be getting constant feedback from their valued users and keep improving their product.

Make sure they provide 24x7x365 support otherwise all the above is not as attractive as it sounds!

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