Legislation tackles offshore teleradiology

Regulatory initiatives percolating at the state and federal levels would require licensing of overseas radiologists, potentially putting the brakes on the burgeoning practice of offshore teleradiology.

Critics of the growing use of offshore services say the practice raises questions of diagnostician qualification, liability, and patient privacy.

Legislation introduced April 14 by Rep. Edward Markey (D-MA) and Sen. Hillary Rodham Clinton (D-NY) would require that the patient be notified whenever offshore teleradiology services are used.

The Safeguarding Americans from Exporting Identification Data (SAFE ID) Act is intended to protect the privacy of consumers' most sensitive personal information, according to Clinton. It covers both medical and financial records. A similar bill, introduced in 2004, died in committee.

Clinton said that the legislation could close gaps in privacy laws that leave consumers vulnerable when U.S. businesses and healthcare organizations send medical information overseas for processing, usually without the patient's knowledge.

"The growing trend of processing sensitive personal information like medical tests makes it even harder for consumers to protect themselves against misuse of their personal information," Clinton said in a prepared statement. "Most of the time, consumers have no idea this practice is being used, and they have no say in the matter."

Jon Berger, vice president of sales and marketing for Nighthawk Radiology Services in San Diego, said he does not consider the proposed legislation a major threat to his operation. All Nighthawk Radiology Services offshore radiologists are U.S.-trained and certified, and all are U.S. citizens stationed temporarily in Zurich, Switzerland, or Sydney, Australia. They are also on staff to the hospitals for which they are interpreting the exams.

"The most that would happen is that a patient would sign a consent," Berger said. "That wouldn't be a big impact from our perspective."

Dr. Arjun Kalyanpur, CEO and chief radiologist for Teleradiology Solutions, a teleradiology provider to U.S. hospitals based in Bangalore, India, had a stronger opinion. He doesn't believe the proposed law would benefit U.S. healthcare.

"The nighthawk teleradiology industry has evolved in response to a need felt by hospitals in the U.S.," he said. "There is a shortage of radiologists willing to work the graveyard shift."

Placing board-certified radiologists in a time zone favorable for U.S. nighttime coverage is what international teleradiology is all about, he said. This has led to improved patient care.

"Legislation that seeks to limit such services would effectively be shooting U.S. healthcare in the foot," Kalyanpur said.