Technology and innovation are key drivers of advancement in a variety of industries, and certainly in healthcare. The level of patient care can be improved considerably with the right mix of traditional and innovative treatments and solutions. Nevertheless, there are regulatory challenges to overcome.
Teleradiology is one area where technological advancements allow for big steps forward. What is it?
Isn't radiology where the x-ray is?
Traditionally, in case of an x-ray, MRT or CT scan, the radiologist analyses the scan at the location where the scan is taken. From a purely technological perspective, this clearly does not have to be the case. A radiologist at a remote location far away from the patient and the scanning device can instantly transmit instructions, analysis and a diagnosis using modern means of communication.
In essence, teleradiology is the ability to obtain an x-ray, MRT or CT scan in one location and to transmit it over a distance for diagnostic or consultative purposes to a radiologist who is not in the same location as the patient.
Futuristic and unnecessary? Quite the contrary. Think about remote geographical locations, such as small hospitals or outpatient clinics in rural areas, urgent treatment situations with no radiologist available or scans required during off-peak hours (e.g. during night-time or on weekends).
... or where the radiologist is?
Teleradiology allows health institutions to provide better patient care. It addresses the lack of qualified radiological staff, especially where a specialist radiologist is needed, such as a paediatric radiologist or a neuro-radiologist.
When considering how to implement teleradiology, healthcare institutions will look at the services of outsourcing companies or radiology groups. This will mean establishing a new contractual framework, which requires careful preparation and implementation to ensure it is designed and works in a compliant, efficient and satisfactory manner.
Key legal issues
- Is it permissible for a radiologist to not be physically present at the patient's location or does this violate Section 49/2 of the Austrian Act on the Medical Profession (ÄrzteG), which states that a physician must exercise his profession in person and directly?
- If teleradiology is permitted, who needs to be physically present at the patient's location to take the scan and what does their (minimum) level of qualification have to be?
- Is teleradiology permissible in all instances or only under limited circumstances, e.g. in case of emergencies?
- If teleradiology is permitted, must the radiologist be in Austria or may he also be located abroad? Do foreign radiologists have to be admitted to practice in Austria?
- What are the key contractual provisions of the underlying outsourcing agreement and how can the regulatory requirements be adequately translated into a working contractual setup?
- How to secure and manage the transfer of data in the context of teleradiology in compliance with the law?
In Austria, the Regulation on Medical Radiation Protection (Medizinische Strahlenschutzverordnung (MedStrSchV) defines teleradiology and provides further guidance on certain of the above issues. In addition, the Law on Security Measures when Processing Medical or Genetic Data (Gesundheitstelematikgesetz 2012) contains further applicable provisions.
While regulatory challenges remain, and need to be carefully considered, measured against the core criteria of whether a new solution improves patient care, teleradiology offers a number of benefits. Ultimately, teleradiology is a way of providing high quality care that otherwise may be unavailable.
1. Credit goes to Dr. Gordon Euller for the invaluable practical insights he provided in connection with this newsletter. http://www.euller.eu/fuehrungskraefte/gordon-euller/
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