ACR Teleradiology Task Force Proposes Guidelines

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The 1-year-old ACR Teleradiology Task Force has published its first best-practice guidelines for teleradiology in the Journal of the American College of Radiology ( JACR).

The recommendations of the group were guided by their four central principles for all teleradiology activities:

1. All teleradiology relationships should be patient centered and “secondary incentives, financial or otherwise, should never supersede patient primacy.”

2. On-site coverage is preferred, and teleradiology services should ideally be supplemental to a comprehensive on-site radiology practice.

3. Teleradiologists and on-site radiologists should both follow the same professional standard of quality.

4. Teleradiology service should not be outside of local safety and quality operations, and it should be assimilated into the usual medical staff credentialing and privileging process.

The Task Force’s whitepaper than goes into great detail on what it sees best practices for teleradiologists themselves, teleradiologists’ work environments, interpretive services, payment considerations, regulatory concerns, and technology-specific considerations such as integrating systems to avoid mistakes due to manually re-entering crucial data like patient identifiers.

It recommends that the ACR itself monitor the evolution of teleradiology and continue to refine its guidelines and standards for teleradiology. A concern of the task force was that currently, communications technology, while far advanced from just a few years ago, still cannot match the direct communication and relationship building that occurs when an on-site radiologist works directly with referring physicians, radiologic technologists, sonographers and patients.

However, it also chided on-site radiologists who complain of “predatory” practices from teleradiology companies. “First and foremost, radiology groups must understand that they create opportunity for competitors when they fail to satisfy the legitimate demands and expectations of their hospitals,” the authors wrote.

As long as both teleradiologists and on-site radiologists are required to adhere to the same standards of high quality health care, the ACR should not take sides, the task force held. However, it could do more to educate and inform their on-site radiology members on “how they should be changing to enhance their provision of noninterpretive services that may become critical to maintaining a presence at their respective facilities.” For example, training for hospital system leadership roles and improving patient care so that they will be harder to replace with “a corporate entity.”

“The recommendations and action items offered in the paper are vital to ensuring that patients remain at the core of the care that radiologists provide as technology and healthcare delivery systems advance,” said Ezequiel Silva III, MD, chair of the American College of Radiology Task Force on Teleradiology Practice.

Read the ACR Whitepaper on Teleradiology Practice.