Start-ups capitalize on time zone teleradiology for night coverage

Night-call coverage has become an imperative of modern healthcare, and healthcare providers are becoming increasingly dissatisfied with radiology business as usual. What used to be a casual on-call duty has become an on-site necessity. Clinicians want access to radiologists around the clock, and short-staffed radiology departments and practices are finding it ever more difficult to comply.

This emerging necessity has spurred some entrepreneurs to create teleradiology companies that exploit global time zone differences and turn night into day. Chip Truwit, director of neuroradiology at the University of Minnesota, joined with two university-based colleagues to form Virtual Radiologic Consultants (VRC), a company that is already fulfilling night-call contracts with U.S.-trained radiologists

in the south of France. Dr. John Haaga, director of radiology at University Hospitals in Cleveland, has formed Global Nighthawks. The company, set to launch formally at the RSNA meeting in November, will provide teleradiology services under contract using U.S.-trained radiologists based in Australia.

“Within two to five years, the staffing shortage will get worse,” Haaga said. “We think we can provide a situation that’s a true win-win for radiologists, because most would love to give their night call away.”

Dr. Arjun Kalyanpur, a Yale University radiologist who practices in Bangalore, India, has formed Teleradiology Solutions. Even university hospitals like Yale, which handles heavy volumes of scans during the night, could use backup help, Kalyanpur said, as could radiology groups that serve smaller community hospitals and manage five to 10 studies a night.

The increase in night call is colliding with a radiology staffing shortage that hovers around 20%, a gap that won’t be narrowed anytime soon, according to Truwit.

“It’s going to be at least seven years before we have anywhere near enough people to meet the demand,” he said.

In addition to lightening the nighttime load, offshore teleradiology may also offer increased diagnostic quality, according to Dr. Paul Berger, who heads Nighthawk Radiology Services in Coeur d’Alene, ID. The company began providing on-call coverage from Sydney, Australia, earlier this year, using a pair of U.S.-trained radiologists.

“If you’ve got dedicated people reading during the daytime, the quality is going to be better than if you are reading the same scans after being awakened several times during the night,” he said.

And outsourcing night-call could also bolster a practice’s bottom line, Haaga said.

“Most people with a reasonable-sized group will have someone take the next day off after being on night call,” he said. “So they basically lose a full-time equivalent from their own schedule. This is a convenient way for groups to provide a service that’s required and actually recover an FTE for their practice.”

These four entrepreneurs exemplify a burgeoning business model, Truwit said. The current enterprises are unlike Telequest, the Wall Street-backed consortium of super-teleradiologists that failed spectacularly this year. Services like Virtual Radiologic Consultants are aimed at the right problem at the right time.

“Telequest failed because it was capital-intensive and it tried to solve the wrong problem,” Truwitt said. “Radiologists are very well trained; it’s arrogant to think that they need subspecialty expertise on a regular basis. Today, the equipment is cheap and the Internet is fast. The problem that needs to be solved is labor-finding radiologists.”

Truwit expects increasing commercial interest in time zone teleradiology and believes that large commercial operations not affiliated with academia might be attracted to the opportunity. Within the next three years, he predicted, the business landscape will have changed dramatically.

“We’d like to believe we’ll still be part of the field, but we’re not naïve enough to think that things aren’t going to change,” he said.

But university-backed services have a very good chance of staying the course, even after global teleradiology catches on as big business, Haaga said.

“Universities have the best international connections and relationships, and the ability to carry out quality assurance and oversight,” he said. “It’s what we do on a daily basis. It’s a perfect niche market for academic centers and affiliated sites.”