Breast-imaging patients and the radiologic technologists who serve them have long wished for a breast radiologist to be there for them—on call or already present—whenever questions or concerns arise in the exam room. Their wishes are now being granted, and the dawning of this new day owes largely to patient-facing, technology-based solutions like vRad’s new Live Video Diagnostics (LVD) solution.
The 50-state, nearly 500-radiologist telemedicine practice headquartered in Minnesota launched the offering in September. It’s been pointing to the future by showing its appeal to vRad’s client practices ever since.
“The idea came to us during a brainstorming session, and client interest has been overwhelmingly positive,” says Arlene Sussman, MD, the vRad medical director who oversees breast imaging practice-wide. “We knew the upfront work and development hours would be well worth the investment to provide an accessible way to make medicine in general, and radiology in particular, less anonymous and more personal. There isn’t a single site that doesn’t love it.”
Here’s how it works. Using innovative end-to-end Cisco networking architecture and a high-resolution 22-inch monitor, LVD connects a vRad breast imaging specialist—all of whom are board-certified and fellowship-trained—with the imaging site in real-time via video conferencing.
On designated workdays, patients, technologists or both of them together can, in real-time, video conference with a vRad radiologist. Mammography technicians can review and annotate images with the radiologist’s guidance and plan detailed next steps. And patients can receive personalized and compassionate care by reviewing their images and speaking directly to a vRad radiologist minutes after their diagnostic screening.
In this way it can “fill in the gaps,” Sussman says, “when attending radiologists are offsite, occupied or otherwise unavailable.”
“We’re face-to-face with patients and technologists,” says Sussman. “The only thing I can’t do is give the patient a hug.”
The first vRad client site to install LVD, the Center for Women’s Imaging at Medical Center Hospital in Odessa, Texas, reports that imaging-exam durations have been cut from as much as an hour and a half to as little as half an hour.
LVD “allows us to provide results almost immediately,” says Carol Evans, RT, the center’s divisional director of radiology. “We either release the patients or, if there is an issue, send the results to their physician within hours—not days. This significantly improves the overall experience, care, and satisfaction for our patients.”
The time savings has further allowed the center to schedule more patients per day, building volume and better serving the community, Evans says. She emphasizes that LVD doesn’t replace the center’s onsite radiologists but, instead, seamlessly fills in for them as needed.
“Having technologists and patients speaking face-to-face with a radiologist,” she says, “is priceless.”
vRad’s live video diagnostics program has already proven itself more than just a worthwhile communications tool. It can also be an accreditation saver, Sussman says.
She recounts the recent case of a rural site in Texas that was in danger of losing its Breast Imaging Center of Excellence designation from the American College of Radiology.
The site had lost its only breast specialist to a tragic accident. Along with working through the heartbreak, the team had to press forward knowing that recruitment of an equally qualified replacement wouldn’t be easy, given their rural location.
“The facility contacted us for immediate assistance,” Sussman recalls. “We explained that working with LVD would be like having a highly credentialed breast imaging specialist sitting right there in their facility. They were thrilled.”
vRad expedited the LVD installation, and the story doesn’t end there.
“Not only did we save the day for them, their facility and their accreditation, but the patients themselves are loving it,” says Sussman. “They love that the center represents cutting-edge technology and that, by using the technology for themselves, they are up on the latest and greatest.”
Meanwhile, the staff likes that radiologist coverage will never again be an issue.
“Because there are so many of us at vRad, there is no interruption to service levels when somebody goes on vacation,” says Sussman. “There are no weekend misses, nothing like that. We can cover all our client sites 24/7 because we have the manpower, and because 75% of our 500 or so radiologists are subspecialty trained.”
Today breast imaging, tomorrow the world?
vRad is only offering LVD to its breast-imaging client sites right now, but Sussman expects that will change.
“I envision this eventually coming to emergency rooms everywhere,” she says. “We would read that head CT right away, connect visually with the patient or the family and go over the images right there, on the spot. That face-to-face contact with the interpreting radiologist builds trust. And it’s just great care.”
It makes sense that the practice would start its video program with breast imaging, given the subspecialty’s high need for radiologist engagement with patients and technologists.
Additionally, breast imaging is among the subspecialties for which vRad is recognized as a leading provider. Even without the LVD, the practice returns mammography results within 48 hours, on average, and it handles BI-RADS tracking and all clinical and regulatory requirements for its client sites.
vRad’s breast team also provides lead interpreting physician services to client sites that need the help to meet standards set by the FDA’s Mammography Quality Standards Act (MQSA). These services include assessing quality, aiding with auditing and tracking, and preparing for inspections.
More than half of vRad’s breast imaging clients avail themselves of the practice’s lead interpreting physician services, Sussman says.
‘We can be that person’
Sussman, who is widely regarded as one of the leading voices championing women’s health in the U.S.—if you watch enough national cable news, you may have seen her doing just that—says she sees live video diagnostics not only expanding beyond breast imaging but also beyond direct patient care.
“Imagine all those multidisciplinary centers that have academic conferences and tumor boards to collaborate on cancer care,” she says. “With video diagnostics, there is no reason vRad’s breast team can’t participate. We are highly specialized cancer care professionals. When the only thing stopping those meetings is the lack of a board-certified breast radiologist, we can be that person.”
So forward-looking is the team that, soon, they will unveil a mammography reading platform designed in-house at vRad, Sussman shared.
The platform will “incorporate all the mammography technologies that are currently out there,” she says. “We looked around and decided to build our own. This has been a labor of love for more than two years now. It’s FDA approved, and we are almost there” with a go-live date.
Asked to comment on how personally satisfying she finds it to practice breast imaging in the setting of telemedicine and video conferencing—potentially reaching hundreds of sites and thousands of patients—Sussman only pauses a moment to gather her thoughts.
“I know this sounds corny, but this really has been the realization of a lifetime dream of mine,” says Sussman, who worked in breast imaging for a decade and a half before joining vRad six years ago. “I always felt that women, in general, were getting shortchanged out there in the medical world. This is my chance to put them on the map and to make them first and foremost. This is my chance to do that.”
“It is an absolute privilege to be able to enter into women’s private lives in this way, face-to-face, in order to help take better care of them.”