Telerad system helps doctors diagnose patients

Telecommunication is providing treatment a little faster for some patients and making life a little easier for radiologists.

Conversely, for the technicians who work with the radiologists, it sometimes makes work a little harder — at least, a little longer, laughs Jerry Thomason, supervisor of special imaging at Northwest Medical Center in Springdale.

“We hate this technology,” he jokes. “It makes it more convenient for [technicians] to do things after hours.”

Thomason is joking, but it’s true that the technicians he supervises do their work at the hospital while the radiologists, thanks to the wonders of teleradiology, can provide some of their expertise from the comfort of home. For emergency patients — or any after-hours work — that can be comforting and mean that proper treatment can begin quicker.

All the radiologist needs is a computer outfitted with a modem, Windows ’95 and a telephone line.

John Faulkner, director of imaging services at Northwest Medical Center, says the telerad system, as it’s commonly called, works well for the radiologists.

“Any time they can get up and go to their computer at home and give a quick read over their computer to the emergency room physicians, it works great,” Faulkner says.

It’s a little more complicated from the hospital’s end. The technician does the scanning, whether it’s X-ray, ultrasound, magnetic resonance imaging or CAT scan. The image is put on film and then processed through a digitizer that converts it into an electronic medium.

Then the technician transmits the data over telephone lines to the radiologist’s home.

“They’re able to review images after hours, on weekends,” all without coming into the hospital, Thomason says.

“They roll out of bed … slip the computer on, look at the screen … and moan about how rough it is,” Thomason laughs again about his colleagues.

But the radiologist’s work doesn’t end after the home scan.

“They do a ‘wet reading,'” a term that dates from the early days of X-ray when film was developed with wet chemicals, Thomason says. Actually, he explains, it’s a “very quick reading” because the image that’s transmitted doesn’t contain all the fine details that the film does.

“A certain percentage of the data is lost due to inherent line static and such, but it’s a very small amount,” Thomason says.

The image is clear enough, however, that the radiologist can usually tell whether things look abnormal.

In the case of an emergency trauma patient who may require surgery, the radiologist receives the images at home. If, after reading the images, he discovers the patient has a lacerated liver, he notifies the emergency room doctor who in turn notifies a surgeon.

It’s the radiologist working as a team member with the emergency room physician and the trauma surgeon, Thomason explains. “Sometimes, [the radiologist] will elect to come to the hospital and actually view the hard copy during those situations.”

Faulkner says the use of teleradiology helps the emergency room physicians, too, because the radiologist is giving a second opinion. The six radiologists who practice at Northwest Medical Center take turns being on call so, if the need arises, they can look over images at home.

The system is also good, Faulkner says, because Northwest’s sister hospital, Bates Medical Center in Bentonville, has only one radiologist on staff. He can easily get a second opinion by relying on his Springdale colleagues to look at an image transmitted by the telerad system.

Prior to the introduction of teleradiology, film traveled the old-fashioned way: Federal Express. “Or the radiologist got out of bed at night” and came to the hospital, Thomason says.

Thomason says there is no central hub but locations are networked together.

“If I want to send films to Bates Hospital, I could do that. If they want to send film to my radiologist at his house, they can.

“I can send anywhere there’s a PC, a telephone line and a modem.”

The equipment needed to digitize and send the images, however, is a little more costly — about $60,000, Thomason estimates.

He figures Northwest uses the teleradiology system half a dozen times a day, usually during non-traditional work hours on weekends and late evenings, since technicians now work until 8 p.m.

In addition to allowing for quicker treatment in emergency cases, it also helps the hospital avoid a backlog of patients.

“A key to hospital viability — besides good care — is giving good care as quickly as possible,” Thomason says. “If you can perform a procedure that has a direct impact on a patient’s treatment, either by having surgery or [other treatment] the next day or by being able to [have the patient] discharged the next day, you’ve saved the patient a day’s stay in the hospital.

“If you somehow assist in making the diagnosis, you’ve expedited treatment.”