Survey finds satisfaction with teleradiology, but room for improvement remains

With teleradiology case volume growing along with radiologist experience, a new survey probes whether radiologist satisfaction with the system is likewise increasing.

Overall, the study found that radiologists are generally satisfied, although some improvements can be made.

The University of Arizona conducted the survey (J Digit Imaging, 2003 Oct 2 [Epub ahead of print]) of 23 full-time attendings as well as 10 third- and fourth-year residents in radiology. It revealed that radiologists believed teleradiologic image quality to be excellent/good, although plain film and ultrasound had more fair/poor ratings.

Monitors, navigation, image processing, and Web-based reporting were rated as excellent/good. The voice recognition system was rated poor.

Diagnostic confidence was about the same as for film. With MR imaging, ultrasound, and plain film, however, up to 10% of cases are unreadable because of poor image quality, not enough images, or inadequate patient history, the report said.

"One important measure for assessing the impact on the radiologist of providing teleradiology (and PACS) services is to measure user satisfaction," said lead author Elizabeth Krupinski, Ph.D., a research professor of radiology at Arizona.

Survey questions addressed reading volume and modalities, image quality, diagnostic confidence, interface issues, and key positive and negative aspects of the teleradiology program.

While it is difficult to separate teleradiology from PACS in terms of research findings and clinical practice, the impact of teleradiology - probably the most mature and well-established clinical specialty within telemedicine - on radiologists can be significant, Krupinski said.

"In many respects, from the perspective of the radiologist, PACS is simply a shift from one display medium to another," she said. "But studies have shown that radiologist workflow improves as well, because there are fewer interruptions, an increased sharing of work, faster/better access to old images and reports, and less paperwork."

Although the increase in workflow may leave time for radiologists to read more images, unless the hospital itself has an increase in the need for imaging services, the actual volume of cases is not likely to change significantly simply as a function of going filmless.

"Teleradiology, however, typically represents an increase in case reading volume and thus generally requires some adjustments to be made in department operations and management," Krupinski said.