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Time and Teleradiology

By Jim Knaub

Rumors of the death of preliminary reads have been greatly exaggerated if you ask Eric Trefelner, MD. Granted, Trefelner and his colleagues at NightShift Radiology have a horse in this race. The Calfornia-based teleradiology group announced at RSNA 2013 that it will stop offering final reads to customers.

“We believe the reputation of the teleradiology industry is being tarnished by large national companies who might be more interested in supplanting customers rather than supporting them,” he said. “To avoid this perception, we have declared that final reads will no longer be included in our service offering. This move reinforces our commitment to being a trusted partner, never a replacement, by supporting community-based radiologists in delivering exceptional service.”

Trefelner and NightShift cofounder Michael G. Myers, MD, admit their position swims against the current of a teleradiology industry moving toward final reads. But speaking with Trefelner at RSNA, he’s not at all convinced the group is swimming upstream alone. He said the company is busy and adding new customers—many of whom he says are finding their way to NightShift because of dissatisfaction with other teleradiology providers.

How far and how fast the transition to final reads will go remains to be seen. Will practices like NightShift be niche practices of sorts or will a significant slice of the market remain preliminary reads? Supporters of teleradiology final reads point to prompt turnaround, decreased cost, and maintaining a single standard of care as reasons for teleradiology final reads. Proponents of preliminary reads say that approach best supports the traditional local radiology group that has been the backbone of diagnostic imaging.

As image- and information-sharing technology improves, teleradiologists have better, more consistent access to prior images and medical records to help inform their reads, which should minimize potential differences between preliminary and final reads and likely move teleradiology toward more final reads.

Perhaps just as important, more radiologists will become accustomed to the mix of on-site and teleradiology reads. What the industry now calls hybrid radiology practice will simply become radiology practice as more physicians work their entire careers in such practice arrangements. But not just yet, according to Trefelner and NightShift.

— Jim Knaub is editor of Radiology Today.