Collaborative software solves off-hours staffing shortage in Scotland

A remote Scottish island hospital is testing the concept of virtual shared workspaces to offer 24/7 radiology reporting in emergency cases. The software solution allows multiple authorized users, working in different locations, to discuss their findings while viewing the same images.

Western Isles Hospital, Stornaway, is the only hospital on the Isle of Lewis. It serves a community of about 25,000 people. Radiologists are not always available to provide off-hours diagnoses. Critically ill patients may instead face a 150-mile air ambulance flight to a mainland hospital. This not only delays diagnosis and treatment but lands the hospital with a £5000 ($7500) bill.

The collaborative software platform chosen by the Stornaway hospital for off-hours teleradiology offers a secure means of accessing images over the Internet, using 192-bit encryption. Radiographers at the island hospital who require an urgent expert opinion can add their patient's images to an online workspace. They then alert a consultant radiologist on the mainland, who is sent the URL for that case by instant messaging. The remote radiologist submits his or her report to the shared work area for immediate access and action.

The system was installed at the end of December 2002 and was initially put to the test during the New Year period. Dr. John Murchison, a consultant radiologist and honorary senior lecturer at Edinburgh Royal Infirmary, reported the first set of CT scans loaded onto a shared workspace while working from home on a PC.

"I typed in my report, which became available at once to anyone with access to that particular workspace. Staff on the Western Isles could then read my report direct," he said. "I also phoned up the hospital to let them know it was there."

Subsequent trials took place on weekends throughout the year. Western Isles now hopes to extend the arrangement and formalize a teleradiology service with hospitals in mainland Scotland.

Murchison hopes to instigate expanded participation in the scheme, although he suggests that the secure workspace solution could be improved still further. Addition of voice recognition, to remove the need for typing, could speed up the reporting process, he said.

"The cooperative element has great potential. Different people can look at the same image or report simultaneously, and there are possibilities for interactive communication," he said.

Because images are transferred over the Internet, however, the system is subject to the same bandwidth constraints as Web-based teleradiology systems. Radiographers at Western Isles initially used a telephone line to upload images, leading to delays. The hospital has now installed a broadband connection to speed up data transfer, Murchison said.