6 Keys to Selecting a World-Class Teleradiology Provider

Part of the challenge to selecting a teleradiology vendor is looking past the concept of these services as mere commodities. It is true that in many cases a practice can come to the negotiating table with price as the foremost concern but simply choosing the lowest-cost provider could be sacrificing numerous value-added features.

“With so many players in this space, there is significant pricing pressure,” said Rob Kill, Chairman and CEO of Virtual Radiologic Corporation, Eden Prairie, MN. “While many providers can compete on price, not all of them have established reputations when it comes to quality of care and service excellence. Undoubtedly we are living in a cost-focused environment, but ultimately we are talking about patient care and you can’t make decisions on patient care based only on price.”

Another point to consider is how the teleradiology provider handles discrepancies. In this regard, it helps to understand the provider’s quality assurance (QA) processes. Some vendors have dedicated QA committees while others will provide more ad hoc QA reviews. Additionally, some vendors will overread a certain percentage of studies in an effort to continually control quality.

When looking to extend your practice’s service offering, a teleradiology company can often times provide subspecialty reads, although generally the larger groups are the ones who offer this level of service. Typically, smaller groups with <10 radiologists are not capable of providing true subspecialty service.

Increasingly, the market is demanding final reads instead of preliminary reads. As scrutiny of healthcare expenditure, especially the cost of medical imaging, continues to escalate, administrative agencies like the Centers for Medicare & Medicaid Services (CMS) are beginning to consider preliminary reading as an inherently inefficient process. In fact, CMS will currently not reimburse for studies that are read in foreign countries, because billing is done for the radiologist’s location and not the patient’s location. So it is also important to ensure that the teleradiology provider has a CMS-compliant billing process in place.

Finally, it is important that the provider can deliver on the technical integration of teleradiology. Specifically, the provider must have a way to get the report back into the hospital’s radiology information system (RIS) or hospital information system (HIS).

An additional factor to consider is how quickly the provider turns around images and how they route images to their radiologists. Some providers can guarantee a consistent turnaround time <30 minutes. However, longer turnaround times for nonemergent cases could help a facility better tailor an SLA to its particular budgetary needs.

“When competing for business it almost always comes down to a combination of price, turnaround time, availability and a certain QA level,” said Howard Reis, Director of Business Development at Imaging on Call, Poughkeepsie, NY. “We see that a 30-minute turnaround time has been fairly standard but the turnaround number can change as you go from preliminary reads to finals. However, nonemergent cases can be read at a slower turnaround time, perhaps 2 hours, and these specifics could be built into the SLA.”

It is also important to discern how images are routed to radiologists. Some providers have elaborate routing schemes and employ radiologists who read in centralized locations vs. radiologists who read from home offices. The benefits here are that workflow coordinators can route calls so that the radiologist who interpreted the study, or another qualified radiologist, is always available to discuss results with referring physicians. In some business models these workflow coordinators also do initial review of the studies to ensure that they are complete and that the study finds its way to the proper physician.

The teleradiology market is becoming a practice necessity across the country.With radiologists, in general, at a premium, the old contention that teleradiology services help foster a better quality of life, and thus happier and more productive radiologists, cannot be overlooked. Selecting the right teleradiology services provider can ensure that referring physicians, and ultimately patients, receive asimilarly high quality of care no matter what time they present to a hospital.

For expanded coverage of this topic, visit www.appliedradiology.com.