Teleradiology's Contribution to Timely Emergency Diagnoses

Need gap of emergency radiology service in India

Over the past few years, there has been a steady rise in emergency cases in India, owing to the rapid rise in our population, non-communicable diseases such as stroke and heart attacks, road accident cases, etc. For example, a survey by the World Health Organization in 2013 suggested that India accounts for 6% of the global burden of road traffic accidents. Similarly, 52% of deaths due to heart disease occur in people below 70 years of age in India. Another report published by the NITI Aayog in 2021 suggests that emergency cases account for 19-39% of all hospital admissions in various hospitals across India. 

Emergency cases need prompt management to avoid death and disability and imaging plays a critical role in aiding diagnosis and guiding appropriate interventions. Emergency settings require the service of round-the-clock specialist radiologists for prompt diagnosis and management. Currently, there is a huge shortage of radiologists globally. India has only about 20,000 radiologists for a population size of about 1.4 billion. It is not uncommon for radiologists to handle both emergency cases along with routine exams which can lead to significant workload challenges. The pandemic has further highlighted a sudden rise in emergency cases can become overwhelming and lead to the failure of our existing healthcare system quickly, without a backup plan. 

Role of teleradiology in Accelerating Emergency Diagnoses

Teleradiology is transforming medical imaging, allowing remote radiological interpretations for faster diagnoses and enhanced patient care. This technology eliminates distance barriers, providing 24/7 access to specialized radiologists, especially in emergencies. Teleradiology enables the transmission of medical images over long distances, improving accessibility and ensuring prompt diagnoses. It also accelerates reporting, reducing patient wait times, promoting teamwork among specialists, and bridging healthcare gaps. With ongoing developments, AI integration, and collaboration with healthcare BPO services, teleradiology's future holds improved patient outcomes and global healthcare efficiency. It enhances efficiency, scalability, and cost savings, making it a vital tool in medical diagnostics.

• Decreases report turnaround times

Several studies in the Western population have shown to improve patient care in emergency departments significantly after the adaptation of teleradiology services in their hospitals. With the availability of teleradiology services, many received the patient report on the same day within a few hours as compared to delayed reporting until the next day in the management of critical conditions. 

• 24/7 coverage 

External teleradiology groups provide continuous coverage for emergency room demands, benefiting patient care by avoiding unnecessary transportation, and unnecessary treatment, and improving the quality of patient care. The flexibility of teleradiology aids in managing surges of emergency cases and critically ill patients, without downfall to meet imaging demands, especially in small and medium-sized hospitals, which cannot afford on-site round-the-clock emergency radiologists. 

• Timely intervention 

Stroke is a leading cause of death and disability in India. Ischemic and hemorrhagic strokes, caused by blocked arteries and brain bleeding respectively, require distinct treatments. The "Golden Hour" principle underscores the importance of quick intervention, as delays lead to neuron loss. While CT scans are crucial for guiding treatment, their complexity demands swift radiologist analysis. Teleradiology and AI are pivotal in this regard. Teleradiology facilitates rapid remote analysis by radiologists, overcoming geographical barriers. Deep learning algorithms in AI, such as NeuralAssist, contribute by promptly identifying brain bleeding, analyzing tissue damage, and locating vessel blockages. These technological advancements are reshaping stroke care, leading to better patient outcomes and brain function preservation.  

Similarly, the use of AI tools in teleradiology allows automatic case triaging warranting immediate attention required in patients with pneumothorax, pulmonary thromboembolism, etc. 

Maxillofacial injuries, which often present in emergency settings are associated with severe morbidity and disfigurement.  Their diagnosis and management on the other hand requires experienced and skilled professionals. As compared to other orthopaedic trauma, the incidence of maxillofacial injuries is quite low and can be appropriately managed in a maxillofacial trauma centre. A study carried out in the western population showed that teleradiology was being successfully to triage trauma patients from peripheral hospitals to a maxillofacial trauma hub centre for appropriate management. Following remote CT assessment, candidates were segregated based on whether they needed surgery or not for the same.

• Better Report quality

Teleradiology services generally involve reporting by experienced specialist radiologists who are trained to accurately interpret medical images in critical patients and their reporting is more focused and directed. AI tools, an integral part of teleradiology help in automatically assigning cases to the best available radiologists, depending upon their expertise and qualification. Moreover, in most cases, the reports undergo a strong peer review and quality assurance process. AI tools are being also used to incorporate standard guidelines and recommendations at all levels of patient care. This helps critical care physicians to deliver the most appropriate treatment promptly, and relevant to the emergency setting. 

• Promotes collaboration among healthcare providers

Teleradiology allows both the radiologist and the emergency care physicians to view patient case reports simultaneously in real time, thereby fostering a culture of collaboration and discussion of complex cases. These communications are highly critical given that most patients in the emergency department require immediate interventions. 

Conclusion 

Emergency admissions account for a significant number of total hospital admissions in India and have a high mortality rate. When compared to other multispecialty units, the nature of cases that arrive in an emergency is diverse and often unknown, requiring a multidisciplinary approach. Emergency radiology has evolved as a subspecialty and plays a crucial role in the early diagnosis and management of emergency cases. Adopting teleradiology has been proven to be both effective, safe and cost-efficient in addressing the unique demands of an emergency department. Teleradiology can play a significant role in managing the emergency radiologist shortage in India. However, it is important to ensure that the teleradiology services adhere to quality standards and maintain patient security.