Covid-19 – Cloudex Radiology

5 Influencing Factors in Teleradiology Reporting

Radiology reporting with shorter TAT aided with tele reporting has brought about significant improvement in patient care outcomes in many departments of medical centers. TeleRadiology report plays a crucial role in terms of diagnosis and treatment planning. And sometimes, a few minutes of waiting period feels like long years and one wonders how to overcome those anxious moments of dilemma. Silence prevails on the patient’s side whereas an array of actions happens on the other side for radiology reporting. So, behind the complexity of radiological image interpretation lies an array of actions involving technology, protocols, coordination, communication, expertise which keep happening seamlessly. Many of these are visible in action status at the reporting stations or work stations of radiologists (on-site/off-site).

The radiologist/teleradiologist’s work-station is made up of hardware, software, and appropriate furniture & interiors. Factors like illumination in working space, ergonomics of chair & table to smallest of an object like a mouse which can possibly trigger the discomfort level to radiologists matters in the process. Briefing out these dynamic factors for understanding behind the scene actions in teleradiology –

1. Hardware:

The dual QHD monitors of size 21 / 30” diagonally equivalent to a 3 or 5 megapixel are used to view the images and write reports simultaneously. This monitor size reduces the need for repeated zooming in or panning out.
CPU with 8th generation, 16 GB RAM, 1GB GPU memory to match the speed of the image interpretation process of the radiologist.
V shaped keyboard and optic mouse with a scroll which contours the fit into adult hand providing the ergonomic posture for convenient working.
Bluetooth enabled headsets helps in audio and dictation.

2. Software:

PACS provides seamless transmission of images in correct order along with other required supporting health documents.
DICOM calibration to meet the DICOM standards which ensures the image displayed is perceptually linearized. This software also provides alerts for out-of-compliance issues through emails/notification.
Notification system alerting the radiologists on an upcoming critical case that needs urgent attention, TAT alarm, call out from other physicians for case discussion/clarification.

Communication platforms contribute in an immeasurable manner. The interaction between the reporting teleradiologist and referring physician is crucial and is a deciding factor and lifesaving in many cases. The alerts/notification / textual or audio messages etc have added speed to the reporting system.

TAT enhancing voice recognition services add lot of value to teleradiology services. It enables teleradiologist in engaging more time in image interpretation and sparing them from initial drafting of reports with features like Real-time self-editing, formatting, auto-punctuation, and electronic signature. It works as workflow accelerator helping in completing the greater number of image reporting in given time frame.

3. Furniture & Interiors:

The versatility of working space supports the radiologist’s long working hours. The ergonomics of the furniture like height of a table, lumbar supporting chair with adjustable seat height are important for comfortable viewing and reporting. This subtlety adds in promoting alertness and efficiency.
Luminance is given special care so as to safeguard radiologists from ocular distress and physical strain. The minimum standards of 350 ccd/m2 is maintained.

4. Connectivity & Server: Speed is the vital part because a lot of activity depends upon it – transmission, downloading, and storage-related rendering or archival of images, interpretation, and reporting of images.

A dedicated reliable high-speed internet connectivity is maintained. The minimum required internet speed is 512 KBPS-1MBPS whereas the speed of 4-8 MBPS is considered ideal enabling a smooth process for interpretation & reporting, and desirable speed is above 25 MBPS for interpretation of large image data set.
The whole process is supported through cloud computing or a quality-controlled web server

5. Cybersecurity: The infrastructure of PACS & DICOM are build keeping in mind the various guidelines provided by HIPPA/FDAs which are further integrated or upgraded with mitigation measures decided by the Teleradiology companies as company policy or SOP decided upon with their clients. Some of the well-known measures are selective encryption of the DICOM header/files, transport security, image de-identification, water-marking or digital signatures, and access to the system thru assigned user ID/password, etc.

Cloudex’s user-friendly work stations delivering customer satisfying results

At Cloudex, reporting stations are configured involving lots of detailing to ensure that teleradiologists are able to concentrate on interpretation and reporting without any distractions/interruptions and operational issues. The reporting platforms are integrated with various software like voice-recognition dictation, multimedia communication, notification apart from the latest PACS & case managing RIS. Importance is also given to illuminance, work-space comfort, sitting ergonomics, monitor configuration for maintaining teleradiologit’s optimal concentration and efficiency. We invest beyond infrastructure too for creating a conducive environment that is free from administrative burdens or logistical hurdles for teleradiologists. The organization’s emphasis on accuracy of reporting without a miss at required TAT facilitates in winning the confidence of referring Physician and scoring high on service satisfaction score.

Cloudex with its wide range of teleradiology services – Emergency, Subspecialty, Nighthawk, Round-the-clock, Weekend / Holiday, Second Opinion; enables the referring physician or medical center in having an edge of being quick, effective, and efficient in delivering patient care. At Cloudex, we support you to have that winning edge.

Role of CT Chest and Teleradiology for 30 Minute Report in Current COVID-19 Pandemic

India is going through a grave crisis with a rising number of Covid cases. People are deprived of timely medical care due to an overwhelmed health care system. People are dying in ambulances and waiting areas for want of beds and essential life support. Health care facilities are facing difficulty in triaging the patients and deciding on whom to treat first. RT-PCR and antigen tests are recording high false-negative rates and there is an inordinate delay in getting the test reports too, which is adding to the delay and confusion in care delivery.

It turns out that the majority of casualties are due to viral pneumonia which is resulting in low blood oxygen saturation levels. Timely diagnosis of the lung pathology and grading of its severity can help save the lives of many. Unfortunately, the endless wait for a diagnosis of Covid by RT-PCR / antigen to decide on hospital admission has taken many a life. There are instances where a breathless patient diagnosed with Covid like pneumonia with CT chest given a score of almost 30 percent of lung affected had to wait for her RT PCR result which came negative twice after waiting nearly 48 hours each time around to get admitted in a hospital. Her wait ended when a hospital agreed to admit her to their SARI (Severe Acute Respiratory Illness) ward despite her RT PCR negative status, but unfortunately, it was too late and she succumbed to the savage virus.

There are innumerable similar deaths happening in all the badly hit cities of India. Hospitals are not able to decide whether to admit or not and if admitted, to the Covid care ward or the non-Covid one. A few hospitals thus decided upon setting up a ward for the breathless and named it SARI (Severe Acute Respiratory Illness) ward like in the case mentioned above. Still, there was a confusion on admission criteria when the Union Health Ministry in its revised national policy for admission of COVID-19 patients on 8^th May said “A suspect case shall be admitted to the suspect ward of COVID Care Centre (CCC), Dedicated COVID Health Centre (DCHC) of Dedicated COVID Hospital (DHC) as the case may be,” in the directive to all the states and Union Territories and that no private or government hospital shall deny admission/care to any patient and that positive coronavirus disease (Covid-19) report is no more mandatory for admissions.

The relevance of a CT chest cannot be emphasized more in the current situation. A CT Chest in the symptomatic patient can quickly assess the lungs and with the help of CORADS score can determine whether the lung is affected or not and classify the disease into non-Covid / low/high possibility of Covid pneumonia. A CT Severity Score of 0-25 out of 25 in the meanwhile can grade the lung involvement into mild (<30%), moderate (30 – 60%), and severe (>60%) disease. The radiologist can quickly assess the CT chest according to these criteria and issue a report, and the quantitative report greatly aids the treating physician to triage the patients and prioritize admission and treatment delivery.

In the current pandemic scenario, the Turn-around-time (TAT) of any diagnostic test (imaging, laboratory, or pathological) plays a crucial role in diagnosis and saving a life. The highly virulent strain of COVID is playing its trick with widely conducted RT-PCR but gets caught in CT Chest. While RT-PCR results are taking up to 48-72 hours at many places due to the unmanageable load, CT chest reports are delivered in less than an hour and are helping physicians in faster diagnosis, prioritization of admissions, and treatment plan for the sick and high-risk patients with comorbidities.

The Healthcare system is facing multifaceted challenges, the biggest one being the shortage of staff and expertise. Hospitals and diagnostic centers are looking for support in a quick, accurate diagnostic process with an unmanageable number of cases every hour. Teleradiology is capable of providing the required support in reporting the large numbers in less time irrespective of the system’s location (urban/rural). Simultaneously serving multiple centers, each teleradiology system has its own team of radiologists and TAT management protocols wherein reports are delivered in promised time despite the large volume.

The teleradiology service providing consistency, shorter TAT, and quality reports benefit the referring physician- aids in diagnosis and guides treatment plan; develops a strong relationship with its client resulting in delivery of quality patient care with high patient satisfaction score.

We at Cloudex have absorbed the gravity of the situation and are working 24*7*365 doing our best to help and serve the country’s healthcare system in this crisis. Our promise to the needy is a report within 30-45 mins for every suspected Covid CT Chest.

Cloudex Radiology Solutions delivers shorter TAT than agreed upon … benefiting referring Physician’s quick action.

Cloudex’s team including administration, operation, and teleradiologists are encouraged to develop a close relationship with the client’s team for familiarity and communication comfort; resulting in delivery of reports within TAT bundled with quality and accuracy. Here, strategically knitted workflow incorporated with advanced technology and expertise ensures the shortest TAT without compromising on the quality that serves & impresses the clients.

The team also emphasizes performance measures, report quality, communication with the referring physician apart from TAT which contributes to the partnered client’s undivided focus on patient care delivery. These efforts of both teams help in remaining competitive and having a winning edge in demonstrating value-based service delivery.

At Cloudex, we support you to have that winning edge.

Panademic Crisis Boon Teleradiology

A medical system by which patient’s radiological images from a variety of health care facilities are transmitted electronically for review and reporting by experienced, offsite radiologists and that’s teleradiology. The resulting reports are then transmitted back to the original facility, providing key insights about the images and helping to determine the course of further patient care. The true fact is that this system is grown within the medical field over the last number of decades, only a few are familiar with the particulars of teleradiology.

Now in the present scenario use of teleradiology is highly recommended as the covid 19 crisis threatens the entire world. Moreover, it ensures the safety of professionals and patients simultaneously. However, optimization of IT solutions and implementation of the right change process is a significant milestone for a successful transition.

Radiology plays an important role during the pandemic as it is essential to maintain the continuity of the health service to the patients. Using such technology based on the transmission of radiological patient images from one location to another and allows radiologists to provide services without having to be in contact with the patient is peculiarly important to minimize the expansion of the covid 19 virus.

In some countries, radiology departments in public and private experienced this solution of remote working, showing a positive impact during the outbreak.

The physical distance between the technologist radiologist, the referring physicians, and the patient is of great advantage now as concerns the present situation. If the concerned patient is in self-quarantine due to exposure to a covid patient, in such situation teleradiology helps much with doctors as being able to read, albeit from far x-rays or CT scan of coronavirus patients.

In China at an early stage of a pandemic outbreak, before swab testing was really available, CT scan was used by doctors to assess the probability of covid 19 infections, same time used to track and monitor the progression of the disease as described by some researchers from China.

Teleradiology allows radiologists to work and be productive when isolated from the rest of their community, while the necessity for social distancing is inevitable in the current pandemic, definitely help to restrict the virus transmission. This practice of receiving images to interpret from a facility and that too is out of radiologists’ geographical vicinity is a truly valuable contribution at this time of unprecedented crisis. By supporting areas of the physician shortage and backing up they are in hospital counterparts, teleradiology serves in a significant way to relieve some of the stresses that global health care systems are currently experiencing.

Medical Science has proven time and again that when the resources are provided, great progress in the treatment, cure, and prevention of diseases can occur.

When there is a crisis we can use two brush strokes to write the word ‘crisis’. One brush stroke stands for danger and the other for opportunity. In a crisis, be aware of the danger but on the other hand recognize the opportunity. It’s really an unpredictable situation for the medical field globally, the danger is on the way we move on. But on the other side of the coin, we are forced to find innovative solutions to problems we may never face before.
When we approach the crisis from a hopeful perspective rather than with a stance of resistance, we can navigate this difficult situation by making it beneficial for the modern medical system knows to be teleradiology.

Tele Radiology

Tag Archives: Covid-19