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Radiology, Day Or Night

February 21, 2011
by Mark Hagland
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Looking at the Results of the First Major Survey of Teleradiology Read Services

Late last fall, researchers at the Orem, Utah-based KLAS Research released a new report, “Teleradiology Study 2010: A Detailed Read.” It was the first time KLAS's team of research professionals had surveyed healthcare leaders on teleradiology read services, what is becoming a rapidly growing field. These services, still sometimes informally referred to as “nighthawk” services, after the Scottsdale, Ariz.-based NightHawk Teleradiology (which last year merged with the Eden Prairie, Minn.-based Virtual Radiologic), one of the earliest companies in the field, have become highly popular among numerous stakeholder groups in healthcare-and certainly are no longer limited just to the nighttime and weekend filling of gaps of available on-call radiologists.


Given the rapid expansion in this field, with hospital emergency departments, radiology departments, multispecialty medical groups, and radiology groups all eager consumers of off-site radiologic interpretations, KLAS's researchers wanted to find out what kinds of experiences these customers were having with these services. HCI Editor-in-Chief Mark Hagland spoke recently with KLAS Research Director Emily Crane about the results. Below are excerpts from that interview.

Healthcare Informatics: Teleradiology services are growing, and most of the ratings are fairly positive [as seen in the figure below]. Your thoughts?

Emily Crane: It's probably a combination of things. I worked in radiology for 12 years, and my personal experience has been that radiologists are very diligent. So a lot of these companies that have emerged have arisen out of that quality of care background. They're business entities, but in many cases, they were radiologists' [personal] dreams.

HCI: So most leaders of these service companies came out of the same background as their customers?

Crane: That's right. And the biggest concern in radiology is getting results to a patient and referring doctor as quickly as possible, but with quality. And this was a unique study for us, because while we do a lot of service organization studies, I think about my family members who are spread out across the U.S., and if one of my relatives were injured, they would be seen quickly enough, and would their diagnostic imaging study be interpreted quickly enough, to allow the needed care interventions to be made? It's easy to see how directly such service questions can relate to care quality overall.

HCI: Given the rapid growth and some consolidation now taking place in the teleradiology read industry, what are your thoughts on the implications of those trends?

Crane: I'll answer that question both optimistically and pessimistically. On the one hand, whenever you can combine services across a larger geographic area, that's a plus. On the other hand, hopefully these companies, if there are mergers or acquisitions, can maintain their high level of quality and commitment, because I'm a very big fan of competition driving quality; so I'm a bit pessimistic there. I hope things remain competitive, in terms of service. And if I were a customer of one of two companies merging, I'd be thinking about what elements I like or don't like about my current provider. And you're looking at one company that will employ the largest number of radiologists in the country; and that could be exciting.

HCI: What's your interpretation of the fact that the ratings tend to be in the same ballpark?

Crane: When they're doing such a very good job, and they're performing such a necessary service, it tends to drive those ratings up even farther. If you're a radiology director, that service is so important. Also, we asked so many different types of respondents these questions, that we got a really good overview. And even though overall there was very high performance, each vendor had certain areas in which they could improve. With regard to one of the vendors we studied, TRS, as an example, people found their involvement was amazing, their ability to provide quick turnaround was amazing; but because of their offshore nature, they don't have the ability to provide a final read without partnership. So that was interesting.

And one of the most surprising things about this is that, for the past two years, there's been a lot of noise in the marketplace about teleradiology companies taking physician contracts, and were they being predatory, or whatever. But in most cases, it just made more economic sense to go in this direction.

HCI: You didn't see broad differences between the larger national vendors and the smaller regional ones, correct?

Crane: Overall, yes, that's right. But access to the actual reading physicians was a little easier with a smaller company, which was no surprise. Overall, these companies were doing a very good job. And people were considering big, national companies alongside these smaller, regional organizations. That was really unique.

For more information regarding this and other KLAS studies, go to

Healthcare Informatics 2011 March;28(3):58-59

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