Ensuring quality in radiology reporting

In the face of 18-week targets, a shortage of radiologists and pressures caused by the European Working Time Directive (EWTD), radiology departments are increasingly looking at options to outsource. According to strategic research company, Medical Options, MRI and CT examinations will each show annual growth of over 10%, while PET/CT will show growth of 24%. X-rays will show slower growth of <2%, but this will add around 500,000 scans per annum. “Examinations are also becoming more complex to read,” commented Medical Options director, Anthony Stevens. “There is more information in a CT image, today – hence they are more time consuming to read. Furthermore, it is the more challenging fields that require a greater level of expertise, such as CT and MRI, that will see the most growth in the future. The number of radiologists will have to grow to meet the increase in scanning demands. “Although the number of radiologists is now on the increase, the numbers will not keep pace with the growth in imaging procedures,” he continued. “In three years’ time, hospital radiology departments will be ‘running to stand still’.” Factors such as the shifting gender balance of NHS doctors, the EWTD, the Government’s stroke initiative and a reluctance to work out of hours, will all present challenges to the availability of radiologists working in NHS hospitals. The new consultant’s contract is also likely to mean less applied time, in his view. “If a doctor is expected to confine their working time to 48 hours, it may be hard for them to justify spending an additional eight hours, for example, in front of a screen reading images from home. In the face of such pressures, Medical Options estimates that the off-site reading market will grow from £7 m (in 2008) to £74 m in 2013. Anthony Stevens pointed out that off-site reporting has shown greater growth and acceptance in the UK, ahead of many other countries in Europe, which has been fuelled, to some degree, by the Government’s outsourcing of scanning services and Independent Sector Treatment Centre programme. This necessitated the reading of images outside of the NHS and opened up the opportunity for companies to provide off-site reporting services. “PACS, and the ability to shift images around from one server to another, has made this possible. But turnaround times for results has been another driver – a number of hospitals have had problems in the past with scans not being read due to backlogs and this was not a one-off occurrence,” said Anthony Stevens. He added that in the field of mammography a certain proportion of studies are “over read” as a safeguard against mistakes, due to past problems at some centres. The health service has tended to be self-governing, with radiologists checking each other’s work, but there is sometimes a need for an independent opinion to ensure quality assurance in his view. Off-site “double reading” of scans is an area which independent providers will be able to address, as radiology departments push to demonstrate quality assurance, he believes.

Imaging Partners Online

 In the UK, a small number of organisations are now helping to address the need for extra capacity and faster turnaround of diagnosis, by providing off-site reporting – whether this is clearing backlogs of images from hospitals, dealing with the legal reporting market or providing out of hours reading. “Each addresses different areas of the radiology reporting market depending on their strengths,” said Anthony Stevens. One of these companies is Imaging Partners Online (IPO). Established in 2007, the organisation is already the largest provider of remote radiology reporting services in Australia. Most recently it has been growing its presence in the UK market. The company provides high quality and flexible remote radiology reporting services to hospitals and other health facilities using UK-based and qualified radiologists, working from a purpose-designed facility in Richmond, west London. Among its clients is one of the country’s largest operators of independent sector treatment centres – Care UK. IPO is not new to the UK – the company’s UK-based radiologists work from the firm’s facility in Richmond during the daytime to provide “overnight” reporting to Australian hospitals. UK restrictions mean that reciprocal arrangements for Australian GMCregistered radiologists to provide “overnight” reporting for the UK market are not yet possible, but in future, IPO hopes this constraint will be relaxed. IPO works hand-in-hand with any radiology department to help to achieve key targets, such as patient waiting times. The client retains complete control as to how and when they send images for it to report on and can request reporting on urgent and non-urgent cases. Every radiologist employed by IPO is GMC specialist registered, but the company’s recruitment processes are particularly thorough – prospective recruits sit a rigorous exam to ensure they meet the company’s high standards and for their first two sessions working on live reports, 100% of their cases are “double read”, regardless of their prior reputation.