European teleradiology center starts primary reads

A pioneering teleradiology practice based in Belgium has begun to provide primary reading service. Eurad Consult now offers cross-border radiological diagnosis to understaffed or overstretched hospitals and medical centers throughout Europe.

The private company was founded in June 2001 by two radiologists. It was initially intended to offer expert opinion on radiological images associated with labor-related accidents and medical liability claims. Anonymized images, often from complex cases, were forwarded securely to one of a panel of international radiologists for interpretation on a DICOM-compatible diagnostic workstation. Images shuttled back and forth through Eurad Consult's central hub, but all actual reading was performed elsewhere.

At the start of 2003, Eurad Consult set up its own premises for radiology reporting in Mechelen, Belgium, having invested in a state-of-the-art PACS and RIS. These facilities allowed the company's directors to hire local radiologists who could report digital images onsite.

The setup effectively addresses two problems, according to Dr. Jan Schillebeeckx, chair of radiology at the Imelda Hospital in Bonheiden, Belgium. Many European countries have a severe shortage of radiologists and struggle to recruit staff. But the problem is reversed in Belgium, where well-trained radiologists cannot find work and waiting lists for CT and MRI are almost unknown.

"We have 1500 radiologists for only 10 million inhabitants in Belgium," he said. "Young radiologists have a high level of training, but some of them are unemployed, so it is easy to find radiologists to work for Eurad Consult."

Eurad Consult radiologists are licensed and insured to report images from Belgium, the Netherlands, Luxembourg, Scandinavia, the U.K., Switzerland, and Austria. The company has contracts with hospitals in the Netherlands and Switzerland, and radiologists at Mechelen have been performing primary reads for these institutions since spring 2003. The teleradiology service steps in when there are staff shortages or a sudden excess of work, but it does not impose strict conditions that might take work away from the hospitals' own radiologists, Schillebeeckx said.

"The most important thing is that radiologists don't feel it as a threat but rather as a help for them," he said. "For instance, at the hospital in Switzerland, the radiologists decide at the end of each day how many CT and MRI exams they are sending to us. Sometimes it is none, sometimes it is one, and other times it is four or five."

Eurad Consult plans to expand its primary read service by targeting countries with acute radiology staffing shortages. The U.K. and Denmark, along with the Netherlands and Switzerland, are likely to benefit most from the teleradiology service, Schillebeeckx said.