Exploring the Opportunities of Teleradiology in the Wake of COVID-19

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With reports of increased productivity and reduced burnout, teleradiology may rapidly become the new normal.

COVID-19 is here to stay, at least for now, and so are many changes brought on by the need for adaptability during the early days of the pandemic. The necessity for physical separation drove many employers in all sectors, including medicine, to embrace remote work en masse in a way that had previously not been common, nor accepted in the mainstream. Old stereotypes of working from home have shifted from a luxury to something that is reasonable for anyone to seek out as their primary employment location. 

Remote working has seen a huge increase from pre-pandemic levels. Roughly 25 percent of all workers will still be working remotely by the end of this year.1 Extrapolation of this data suggest that 36.2 million of the American workforce will be working from home by 2025, almost double the incidence before the advent of the pandemic. 

Advances in technology have made remote work equally, if not more, efficient than traditional office work. Many of the lessons learned from the private sector can be applied to the medical field. Although the adoption of telemedicine has been slow in the past, it is now more viable than ever with a corresponding boom in teleradiology.

With regard to our specialty, teleradiology has frequently been used to offset the exploding imaging requirement during off-service hours or otherwise allow for fulfillment of diagnostic responsibilities at off-site locations. The current utilization of off-hours teleradiology has jumped from 15 percent of practices in 2003 to roughly 60 percent of hospitals today.2 With emergency department imaging use continuing to rise and new techniques further increasing the imaging volume expectations, a symbiotic relationship and understanding of the value of teleradiology is of great importance, even to those who are not interested in remote work.

The value of remote work exists not only in individual preference, but in more concrete benefits to the radiologist as well as the patient and hospital. For those who enjoy working from home, being allowed to perform some responsibilities remotely appears to confer resistance to the ever -present threat of physician burnout. A survey of radiation oncologists during the height of the original wave of the pandemic demonstrated a surprising reduction in burnout from 40 percent the previous year to 32 percent in May 2020.3 They attributed this resilience to their employees’ attitudes regarding working from home with 74 percent reporting a positive experience. Additionally, despite previous misconceptions, working from a home environment outside of a traditional office work setting appears to confer an increased – not decreased – productivity. Remote workers reported increased focus and less unproductive time.4 There are also the benefits of reduced commute time and cost, and the additional free time that comes with that. 

Diagnostic reading work, in particular, is amenable to remote productivity compared to most other telemedicine work since no physical proximity between physician and patient or other staff is necessary. Since remote work can theoretically be done at any distance, these radiologists can efficiently cover large networks of low-volume rural hospitals without any commute.2 Likewise, the use of remote radiologists either in-house or externally sourced to cover overnight call shifts allows physicians to still work during normal hours and reduces the often burnout-inducing frustration of call shifts.

This is not to say that remote work is without its flaws. A common complaint for those who mostly work from home is the inability to disassociate work from home life. It is important to quarantine work responsibilities in a home office, and the lack of one may inhibit the draw of effective remote work. 

Radiology, in particular, requires a high-quality and expensive workstation to simulate the reading experience of in-house work and guarantee the same end product. While many institutions may supply this equipment, this is not universal. Also, remote physicians working across state lines are required to be licensed in both states, reducing a radiologist’s ability to easily do work in multiple states although the COVID-19 pandemic led to temporary reprieve of some of these regulations.5 These regulations may serve to protect radiologists from international outsourcing though. 

Lastly, the complexities of remote work may also be a hinderance to those who are not technologically inclined and may confer challenges in technical support for off-site hardware.

Whether done as a small component of a traditional radiology position or via a stand-alone position, teleradiology has an important role to play in modern medicine. Teleradiologists can help offset burnout and improve productivity and bring increased coverage to rural areas that may not be able to have additional full-time staff. Many radiology responsibilities can be done at home with the increased availability of remote collaboration software. Hospitals should work to offer additional opportunities for staff to spend days without in-person needs at home workstations. In this new, post-COVID landscape, remote work is more accepted, viable, and valuable than ever. It would be a mistake for radiology not to embrace these changes.

References

1. Ioannou L. 1 in 4 Americans will be working remotely in 2021, Upwork survey reveals. CNBC. Published February 6, 2021. Accessed December 14, 2021. 

2. Hanna TN, Steenburg SD, Rosenkrantz AB, Pyatt RS Jr, Duszak R Jr, Friedberg EB. Emerging challenges and opportunities in the evolution of teleradiology. AJR Am J Roentgenol. 2020;215(6):1411-1416.

3. Hoffman KE, Garner D, Koong AC, Woodward WA. Understanding the intersection of working from home and burnout to optimize post-COVID19 work arrangements in radiation oncology. Int J Radiat Oncol Biol Phys. 2020;108(2):370-373. doi:10.1016/j.ijrobp.2020.06.062

4. Airtasker. The benefits of working from home. Airtasker Blog. Published March 31, 2020. Accessed December 14, 2021. 

5. Van Moore A, Allen B, Campbell SC, et al. Teleradiology: American College of Radiology. American College of Radiology. https://www.acr.org/Practice-Management-Quality-Informatics/Legal-Practices/Teleradiology . Accessed December 14, 2021.