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Review medical imaging industry statistics. Ease the challenges faced by radiology administrators, managers and healthcare directors. Understand the changing roles of remote radiology reading services and PACS/RIS administrators. Tap into resources used by imaging technology professionals to make purchasing decisions.  Browse job postings for teleradiology jobs to consider options for advancing your radiologic career. Find a company to provide teleradiology services. Enhance your ability to make wise radiology business management decisions.

Comprehend the growth of the teleradiology industry and consolidations in the teleradiology market space that affect radiologists and teleradiology professionals. Improve your ability to use radiology to diagnose and treat disease. Get ready for the RSNA 2018 annual meeting. Get smarter, stay tuned in and continue your education by periodically reading the news provided by National Diagnostic Imaging.

News

Accreditation Programs For Diagnostic Imaging Centers In The U.S.

December 22, 2022

ACR Accreditation is recognized as the gold standard in medical imaging. The ACR offers accreditation programs in CT, MRI, breast MRI, nuclear medicine and PET as mandated under the Medicare Improvements for Patients and Providers Act (MIPPA) as well as for modalities mandated under the Mammography Quality Standards Act (MQSA). Accreditation application and evaluation are typically completed within 90 days.

The ACR has accredited more than 39,000 facilities in 10 imaging modalities. They offer accreditation programs in Mammography, CT, MRI, Breast MRI, Nuclear Medicine and PET, Ultrasound, Breast Ultrasound and Stereotactic Breast Biopsy.

The Joint Review Committee on Education in Radiologic Technology (JRCERT) accredits educational programs in radiography, radiation therapy, magnetic resonance, and medical dosimetry.

The National Accreditation Program for Breast Centers (NAPBC) provides the structure and resources you need to develop and operate a high-quality breast center. Programs that are accredited by the NAPBC follow a model for organizing and managing a breast center to facilitate multidisciplinary, integrated, comprehensive breast cancer services.

Get information from the Centers for Medicare & Medicaid Services (CMS) about their requirements for accreditation of advanced diagnostic imaging suppliers, here.

The Intersocietal Accreditation Commission (IAC) is a nonprofit, nationally recognized accrediting organization. The IAC was founded by medical professionals to advance appropriate utilization, standardization and quality of diagnostic imaging and intervention-based procedures.

The IAC is a nonprofit organization in operation to evaluate and accredit facilities that provide diagnostic imaging and procedure-based modalities, thus improving the quality of patient care provided in private offices, clinics and hospitals where such services are performed.

With a 30-year history of offering medical accreditation to facilities within the U.S. and Canada, IAC is also now offering accreditation in international markets. The IAC programs for accreditation are dedicated to ensuring quality patient care and promoting health care and all support one common mission: Improving health care through accreditation®.

The ACVR is the American Veterinary Medical Association (AVMA) recognized veterinary specialty organization™ for certification of Radiology, Radiation Oncology and Equine Diagnostic Imaging.

If you are a radiology imaging service in the United States that is looking for a company that can provide daytime, nighttime, weekend and holiday coverage for your current and future case volume, contact National Diagnostic Imaging by phone at 216-514-1199 or by emailing info@ndximaging.com.

Radiology Overreads Services For Medical And Legal Purposes
11/27/18
National Diagnostic Imaging is a physician-owned radiology overread and teleradiology service provider. Our teleradiology company specializes in providing radiology overread services to confirm or refute a medical diagnosis (to rule in or rule out the disease), to detect a radiology or radiological error, Workers Compensation Insurance matters, legal and malpractice purposes. When a customer such as a referring physician or an attorney requests a second opinion, outside read, or overread on a prior imaging exam, radiologist at NDI provide written reports which are submitted to the client that requested the radiology overread service.

Report: Radiologists Offered Average $371K Base Salary, Rank 5th As Most Requested Medical Specialty
08/08/18
National healthcare search and consulting firm Merritt Hawkins released its 2018 Review of Physician and Advanced Practitioner Recruiting Incentives, which listed radiology as the fifth most requested medical specialty searched in fiscal year 2017-2018 fiscal year, up from 10th in the previous year’s report. “Renewed demand for radiologists was inevitable because imaging remains central to diagnostic and procedural work in today’s healthcare system, in which very little transpires without a picture,” according to the report. “The importance of radiology is enhanced with each technological advance (including artificial intelligence) that makes imaging techniques more varied and effective.” More >

Outside The Reading Room: Field Trips Expose Medical Students To Patient-Centered Radiology
08/08/18
Integrating structured field trips to the imaging department during a four-week radiology clerkship could help expose medical students to the patient-centered, team-based aspects of the specialty, according to a review published this July in Academic Radiology. More >

Sectra Signs New Enterprise-Wide PACS Contract With Academic Health System
08/08/18
International medical imaging IT and cybersecurity company Sectra (STO: SECT B) will install its enterprise imaging PACS throughout Stanford Health Care (SHC) and Lucile Packard Children’s Hospital to support clinical and research imaging needs of the organization. The Sectra solution – integrated with Epic Radiant – will ensure business continuity, high system availability, and scalability for future growth. In addition to Sectra PACS for all diagnostic radiology, the multi-year agreement will include advanced visualization tools, teaching file software, Sectra Breast Imaging PACS for mammography workflow, 2D and 3D orthopaedic templating tools, business analytics and a universal viewer. Stanford Health Care is part of Stanford Medicine, an academic health system that includes the Stanford University School of Medicine, Stanford Health Care, and Stanford Children’s Health, with Lucile Packard Children’s Hospital. More >

Second Opinions of Suspicious Breast Screenings Frequently Changes Interpretations
08/08/18
Interpretations of suspicious breast imaging exams change almost half the time with a second opinion, according to a study published in the Journal of the American College of Radiology. Researchers from the Memorial Sloan Kettering Cancer Center in New York City, N.Y., performed a retrospective review to determine the effect of subspecialty review of breast imaging on patients without a diagnosis of breast cancer who self-referred for a second opinion. More >

Radiologists Still Reading More Lower Extremity MRIs Than Nonradiologists, Especially On Weekends
08/08/18
Nonradiologists such as orthopedic surgeons are interpreting a growing number of musculoskeletal imaging examinations. According to a new study published in the American Journal of Roentgenology, however, radiologists are still performing a lion’s share of the work, including a much higher percentage of weekend reads and clinically complex patients. More >

Concurrent Read CAD Software Cuts Breast Image Study Time
08/08/18
Using a computer-aided detection system to read automated breast ultrasounds can cut the time a radiologist needs to interpret images. Screening mammography is an important step in the early detection of breast cancer. However, it’s harder to read mammography screens in women with dense breast tissue. In 2012 the Food and Drug Administration approved the first ABUS system to use in combination with screening mammographies. ABUS systems automatically scan the breasts in six volumetric data sets, thus eliminating operator dependence on handheld breast ultrasound equipment. More >

Real Radiology Acquires Argus Radiology Consultants
08/08/18
Teleradiology firm Real Radiology, LLC has acquired Argus Radiology Consultants, LLC, a provider of 24/7 teleradiology services. The Missouri-based Argus, founded by Jamey Wright, MD, provides services to emergency hospital departments and radiology groups, including overnight and weekend coverage. Real Radiology, LLC is a JCAHO certified, 100% US based radiologist-owned and operated teleradiology company based in Omaha, NE. Real Radiology serves several Veterans Administration and Department of Defense Hospitals as well as private sites and imaging services across the United States.

MEDNAX Radiology Solutions and vRad to Exhibit at AHRA 2018 Annual Meeting July 23-25
Published at Business Wire on July, 19 2018
Posted to Radiology Reading Service And Teleradiology Industry News on August 3, 2018

FORT LAUDERDALE, Fla.–(BUSINESS WIRE)–MEDNAX Radiology Solutions and vRad (Virtual Radiologic), a MEDNAX company, will exhibit at AHRA: The Association for Medical Imaging Management’s 2018 Annual Meeting from July 23-25 in Orlando, Fla. Practice leadership will be on-site at booth #220.

AHRA is the professional organization representing management at all levels of hospital imaging departments, freestanding imaging centers and group practices. The Annual Meeting attracts over 1,000 medical imaging leaders, offering the opportunity to network with industry peers from across the country and gain insight into health care services, tools and trends.

MEDNAX Radiology Solutions is one of the nation’s largest radiology practices, recognized as a leader in radiology, an innovator in health care informatics and a pioneer in telemedicine. The practice serves more than 2,100 leading hospitals and health care facilities nationwide, reading upwards of 11 million studies annually through more than 725 board certified physicians, most of whom are subspecialty-trained. By delivering clinical excellence and continuous coverage through a combination of seamless on-the-ground and in-the-cloud radiology solutions, MEDNAX Radiology Solutions offers unique and tailored solutions to drive growth and value.

For more information, please visit MEDNAX Radiology Solutions online.

About Mednax

MEDNAX, Inc. is a national health solutions partner based in Sunrise, Fla. comprised of the nation’s leading providers of physician services. Physicians and advanced practitioners practicing as part of MEDNAX are reshaping the delivery of care within their specialties and subspecialties, using evidence-based tools, continuous quality initiatives, clinical research and telemedicine to enhance patient outcomes and provide high-quality, cost-effective care. The Company was founded in 1979, and today, through its affiliated professional corporations, MEDNAX provides services through a network of more than 4,100 physicians in all 50 states and Puerto Rico. In addition to its national physician network, MEDNAX provides services to healthcare facilities and physicians in over 40 states through two complementary businesses, consisting of a revenue cycle management company and a consulting services company. Additional information is available at www.mednax.com.

About VRad

vRad (Virtual Radiologic) is the nation’s leading cloud-based radiology services and telemedicine company with more than 500 U.S. board certified physicians, most of whom are subspecialty-trained. Its clinical expertise and evidence-based insight help clients make better decisions about the treatment and health of their patients, as well as their imaging services. vRad is a MEDNAX company (NYSE:MD), a national health solutions partner specializing in anesthesiology, neonatology, maternal-fetal medicine, other pediatric services, radiology and management services. vRad interprets and processes patient imaging studies on the world’s largest and most advanced cloud-based radiology PACS for client hospital, health system and radiology group facilities in all 50 states. The practice has 18 issued patents for innovation in telemedicine workflow and is a recognized leader in imaging analytics and deep learning-assisted diagnostics. It is also a recipient of Frost & Sullivan’s Visionary Innovation Award for Medical Imaging Analytics (North America). For more information, visit www.vrad.com and follow us on Twitter, Facebook and LinkedIn.

Contacts

MEDNAX, Inc.
Jennifer Gutierrez, 954-384-0175 ext. 5684
Corporate Communications Specialist
jennifer_gutierrez@mednax.com

The Association for Medical Imaging Management (AHRA)
http://www.ahra.org
08/03/18
The Association for Medical Imaging Management is the professional organization representing management at all levels of hospital imaging departments, freestanding imaging centers, and group practices. Founded in 1973, AHRA’s 5000 members reach across the country and around the world. AHRA offers a complete slate of professional development programs including a comprehensive selection of educational conferences and seminars, networking opportunities, award winning publications, and the Certified Radiology Administrator (CRA) credential.

Does Cone Beam Computed Tomography Make Sense in Your Dental Practice?
By Ryan O’Neill, DMD
Published at http://www.sleepreviewmag.com/2018/07/cbct-dental-practice/ on July 5, 2018
Posted at Radiology Reading Service And Teleradiology Industry News on August 8th, 2018

The cost of cone beam computed tomography (CBCT) is a common barrier to entry for anyone considering investing in 3D imaging. The cost of a new CBCT can exceed $125,000. How do dentists justify such a large investment?

The answer depends on the clinician, but for my dental practice, I analyzed the various treatment services I was already incorporating or wanted to begin incorporating in my practice. I purchased my first CBCT in 2014. That allowed me to add services to my office that I’d been reluctant to regularly offer, such as sinus augmentations, guided implant surgery, third molar extractions, complex endodontics, and more.

Interpreting CBCT Data

Today, remote radiology reports let clinicians of all types acquire large amounts of data and outsource the interpretation. Companies such as Dental Radiology Diagnostics (DRDx) provide reports of uploaded CBCT data to dentists. According to DRDx’s site, “Many practices routinely have all of their CBCT scans reviewed by a radiologist to eliminate concerns over reviewing the scans themselves and missing an important finding.”

Contact your state dental board before reading or outsourcing any CBCT scans as some states require a license to read the scans. Vet outsourced providers to be sure they have the state license (if needed) and that you are comfortable with the level of education and board certifications of the radiologists who will be reading your patients’ scans.

Sleep Specifics

Sleep Nashville, our dental practice devoted entirely to treating sleep-disordered breathing through oral appliance therapy, utilizes 3D imaging through the airway analysis feature of SICAT AIR, which is the CBCT software we use.

In a study published in 2016 comparing upright CBCT scans on mild-moderate OSA patients versus patients without OSA, the data revealed significantly smaller average airway area, volume and width in those patients with OSA. Interestingly, the mean anterior-posterior distance did not show a significant difference between groups.

In another small study, the CBCT data of mild OSA patients were compared supine versus upright, revealing a total airway volume decrease by 32% when supine as opposed to upright.

CBCT can be used in conjunction with traditional screening tools (Epworth Sleepiness Scale, STOPBANG, etc) but should never completely replace these tools to identify high risk individuals. The possibility of a false negative can be created when patients whose airway awake and upright appears adequate in volume but does not take into account the collapsibility of the airway when asleep and supine. Before and after treatment sleep studies remain the standard of care to diagnose and determine treatment efficacy of oral appliance therapy rather than CBCT imaging alone. However, CBCT scans for other routine dental procedures can often identify high risk individuals as an incidental finding that would prompt a sleep study referral.

In our practice, we find that CBCT airway visualization helps patients understand how mandibular advancement devices (MADs) are effective at improving airflow. Anecdotally, we show an increase in airway volume of 50% to 100% on average in successful MAD responders. Our CBCT is a great conversation starter with patients in helping understand the need for a sleep study, which furthers our collaborative efforts with local pulmonologists.

Final Thoughts

CBCT used primarily for the screening and assessment of OSA alone is not the most advantageous use of this expensive equipment (due to its limitations discussed earlier). CBCT is not a diagnostic tool for OSA and should not replace polysomnography or home sleep apnea testing in the diagnostic process.

Owning a CBCT imaging device is most effective for general dentists who perform a wide range of services, in addition to OSA treatment. My CBCT allows me to screen and educate my patients in such a way that the monthly production generated by my CBCT justifies the monthly expense of my CBCT. SR

The Rising Acceptance of Teleradiology
07/23/18
Teleradiology hasn’t always had a good reputation. Historically, pay was low, interpretations frequently came from overseas physicians, quality might be questioned by local radiologists, and onsite physicians were frustrated that the imaging interpreter wasn’t easily accessible to answer questions. Criticisms of the field continue, with accusations of it devaluing radiology and making radiologists’ work a commodity. However, it’s growing so quickly that some teleradiology companies are turning to recruiters for the first time to fill the need. The field has changed so much so that some say teleradiology is emerging as its own specialty, separate from diagnostic radiology. Add the narrowing salary gap between teleradiology and diagnostic imaging, and it’s a field that’s coming out of its cocoon and spreading its wings.

Questions To Ask Potential Radiology Hires
07/23/18
They are terms and fluctuations you see frequently in real estate—a “seller’s” or a “buyer’s” market. This reality holds true in the radiology employment, too. Depending on which market you are in determines how much control you have in contract negotiations. Right now, the industry is in the middle of a white-hot buyer’s market, and it’s the exact opposite from only five years ago. Today, if you’re a hiring manager, you’re probably keenly aware that filling empty positions has gotten harder over the past year. But, if you’re a candidate, you might feel like you’re holding all the cards. So, with all the market changes, how do you find the best qualified candidate? According to Laura DeJesus, a principal recruiter with Medicus Firm, it comes down to the questions you ask—and what questions potential employees ask you. Ultimately, she says, you must enter employment conversations and contract negotiations as openly as possible. “This process can be straight-forward,” she says. “I tell my clients and potential hires to be transparent about their practice and their desires. You can manage expectations by being transparent, and that’s all anyone ever really wants.”   Asking questions about these topics, as a hiring manager or a candidate, can help you both find the pairing that will best fulfill your needs.

Secondary Imaging Interpretations On The Rise Among Medicare Beneficiaries
07/23/18
Secondary interpretations of diagnostic imaging examinations have increased significantly among Medicare beneficiaries, according to a new study published by the Journal of the American College of Radiology. The authors also noted that denial rates for these secondary interpretations are “uniformly low.” “Concordant with the prior work focusing exclusively on CT, we found broad increases in secondary imaging service interpretations across a variety of imaging services, with some families showing particularly rapid growth,” wrote lead author Andrew B. Rosenkrantz MD, MPA, of the department of radiology at NYU Langone Medical Center in New York, and colleagues. “Of note, these increases occurred despite the absence of comparable growth in primary imaging interpretations.”
Rosenkrantz et al. studied Medicare data to track secondary interpretations of a variety of imaging services from 2003 to 2016. The authors identified such interpretations by looking for modifiers 26 and 77. Overall, between 2003 and 2016, there were more than 9.7 million radiography and fluoroscopy (R&F) secondary interpretations billed to Medicare. There were also more than 568,000 CT secondary interpretations, more than 105,000 for ultrasound, more than 84,000 for MRI and more than 23,000 for nuclear medicine. Looking at changes in the utilization of secondary imaging interpretations from 2003 to 2016, the authors found that cardiac MRI (+35.7 percent), breast MRI (+33.1 percent), abdominal and pelvic MRI (+30.3 percent), unspecified nuclear medicine (+27.9 percent) and head and neck CT (+25.3 percent) had the highest compound annual growth rates. In addition, service family included in the study had a secondary interpretation denial rate of less than 25 percent. It was less than 10 percent for 15 service families, including chest CT (5.2 percent), abdomen/pelvis MR (6.1 percent), chest R&F (6.2 percent), abdomen/pelvis R&F (6.4 percent) and extremity MR (6.5 percent). Rosenkrantz and colleagues anticipated secondary interpretations would be on the rise for CT and MRI, but the data did reveal some unexpected findings. “Surprisingly, we found that secondary interpretations, as indicated by a combination of modifiers Medicare has instructed radiologists to use in reporting these services, overwhelmingly involved chest radiography,” the authors wrote. “In this context, questions arise as to the specialty and subspecialization of health care providers initially interpreting and billing for these services. The extremely high frequency of billed secondary interpretations for chest radiology, we believe, should prompt a closer examination of the specialty and practice site of providers delivering initial services.” The authors concluded that these increases in secondary interpretations should be taken seriously by both policymakers and imaging leaders. “Secondary interpretations have the potential to render more accurate interpretations, alter patient management, and lower rates of repeat imaging examinations, which in turn may entail additional exposure to ionizing radiation and intravenous contrast agents as well as additional costs to patients and health care systems,” they wrote. “Policy considerations regarding appropriate payment for secondary interpretations should consider these downstream benefits.”

Understanding Your MRI Results – How MRI Works and What Terms Mean
07/23/18
When a patient receives an MRI scan, he is placed in a narrow tube. Surrounding him is a very strong magnet. When this magnet is turned on, randomly spinning hydrogen atoms line up in the direction of the magnetic field. A radio pulse is applied to the area of the body to be examined. Atoms in this area absorb some of the pulse’s energy, which leads them to spin in a specific frequency and direction. Smaller magnets are turned off and on in such a way to activate very precise regions known as slices. When the radio frequency pulse is turned off, the hydrogen atoms release absorbed energy, giving off a signal detected by the MRI machine. A computer analyzes these signals and uses them to construct an image of the slice.

The Pleasures And Pitfalls Of Rendering Interpretations In Layperson’s Language
07/23/18
Numerous surveys and studies have shown high patient interest in radiology reports. The momentum is clearly in favor of greater direct-to-patient radiology reporting. However, the consensus among experts and observers seems to be that radiologists need to think like a layperson on the receiving end. In most cases this means checking for clarity over ambiguity, anticipating potential trip-ups and generally taking care to minimize the risk of stressing patients out rather than filling them in. When patients see their radiology images and reports, they often have questions and concerns that no clinician is better qualified to address than a radiologist. Mark Raden, MD, a radiologist with Northwell Health and Staten Island University Hospital, agrees. Time spent discussing images with patients is a good business investment and fosters loyalty, he points out. “We let them know that we exist—‘I am Dr. So-and-So and I’m specially trained,’” he says. “They’re not just getting an MRI of the spine and then seeing a bill with some guy’s name on it.”

New AI Tool Can Tell How Smart You Are By Reading Your Brain Scan
07/23/18
Functional MRI develops a map of brain activity by detecting changes in blood flow to specific brain regions. Scientists have developed an artificial intelligence system that can tell how smart a person is just by looking at a scan of the individual’s brain. Researchers from California Institute of Technology, Cedars-Sinai Medical Center and the University of Salerno in the US show that their new computing tool can predict a person’s intelligence from functional magnetic resonance imaging (fMRI) scans of their resting state brain activity. Functional MRI develops a map of brain activity by detecting changes in blood flow to specific brain regions. Researchers said that they would like to see one day MRIs work as well for diagnosing conditions like autism, schizophrenia, and anxiety as they currently do for finding tumours, aneurisms, or liver disease.

“Virtual Biopsies” May Be The Future Of Understanding Brain Tumors
07/23/18
Dr. Omar Arnaout of Brigham and Women’s Hospital in Boston a team of researchers are taking thousands of patient MRIs, matching them up with biopsy results and allowing a computer program to learn how to identify a tumor, creating a virtual biopsy. That will allow doctors to select the best plan of action and give patients more valuable information about their prognosis.

Doctors at NDI Read MRIs To Analyze Body Structures And Spot Abnormalities
07/23/18
Teleradiologists interpret cardiovascular magnetic resonance (CMR) imaging scans and pictures in order to detect heart problems, monitor cardiac disease and to examine and evaluate coronary blood vessels, veins, valves and the heart’s anatomy. The radiologists at NDI read brain and brain stem MRI scans to detect brain tumors, cysts, swelling, infections, developmental and structural abnormalities, aneurysms, damage caused by strokes, inflammatory conditions, injury to optic and auditory nerves and bleeding in the brain. Radiologists at NDI read and interpret spine, thoracic, cervical and lumbar (lower spine and back) MRIs to identify degenerative disc disease, herniated discs and spinal stenosis.

Industry News: Teleradiology By The Numbers
07/03/18
If accuracy and efficiency are two of the most important requirements for a modern radiology service, new figures from Telemedicine Clinic shows teleradiology can offer them both in spades. In 2017, the company was dealing with up to around 500 on-call scans a night, with up to 95% of readings being performed within an hour. The discrepancy rate was 4.4%, below Telemedicine Clinic’s 5% target and well under the 20% or so level seen in some studies. Although the bulk of Telemedicine Clinic’s work was through on-call services provided via specialists in Sydney, Australia, 90% of elective cases were also completed within an hour. Since Telemedicine Clinic pays its radiologists a fixed wage rather than on a per-scan basis, the high efficiency of the readings is thought to be down to highly efficient workflows and appropriately trained sub-specialists rather than radiologists chasing a premium for extra work. Despite this, Telemedicine Clinic is still on the lookout for talented radiologists to fill vacancies arising from 17% growth in 2017.

Radiology Practices Using AI And NLP To Boost MIPS Payments
07/03/18
RadNet and vRad have deployed natural language processing tools to help them tackle over-utilization and tasks that are hard for humans.  Positive or negative Medicare payment adjustments in 2019 will depend on performance to quality and other measures in 2017 under a new program called the Merit-based Incentive Payment System. Doing well on quality measures is important because they comprise 60 percent of a provider’s total MIPS score – possibly 85 percent for certain specialties such as radiology. Most of the quality measures in MIPS are based on face-to-face patient encounters and are not particularly applicable to radiology. That’s a concern for RadNet, a 300-center outpatient imaging provider.

Why Better Radiology Management Can Lift Revenue, Cut Unnecessary Utilization
07/03/18
The real dollars that are at stake are based on what happens in the radiology report, and what happens next. Imaging is powerful, but if clinicians aren’t doing the right things with that information, the value that radiology has to offer isn’t being captured. The field of radiology is highly fragmented. Sequestered in their own geographic areas, radiologists struggle to adhere to a universal set of best practices, and that has made it difficult for those in the field to decrease unnecessary utilization and reduce costs. But that’s changing. Groups like Radiology Partners have sprung up to bring radiologists together, and according to Radiology Partners CEO Richard Whitney, that scale is absolutely key to making the kind of transformative changes that are needed in diagnostic imaging.

Outsourcing Radiology Billing and Coding
07/03/18
Hospitals, clinics and imaging centers are also welcome to outsource their billing responsibilities to NDI. The company provides direct billing services for our clients who benefit from our comprehensive billing experience. Their administrative staff stays abreast of  individual payer changes, radiology billing regulations, private payer guidelines, contemporary methods for processing Medicare claims.

Radiology Billing and Coding: From In-House Radiology Billing to Outsourcing — Lessons Learned
07/03/18
The medical billing process has evolved from a relatively simple back-office administrative duty to a sophisticated matrix. It has morphed into a system and workflow that requires subject matter experts in CPT coding, ICD-10 coding, technology, claim filing, edits, managing denied claims, holding payers accountable, payer contracting, responsiveness to patients, compliance, and providing meaningful reports to radiologists, practice managers, accountants, and attorneys.

There are two steps to achieving peace of mind regarding your radiology billing process. The first is to assess the costs and risks of maintaining an in-house process to determine whether it is the best pathway for you and your group’s future. Once that decision is made, the second step is to consider and determine the best way to seamlessly transition. A successful transition can enhance your financial strength while simultaneously mitigating your risks.

Teleradiology Services Market to Record an Exponential CAGR by 2026
06/20/18
Teleradiology is the practice of interpretation and analysis of medical images by a radiologist who is not present at the site where the images are generated. This service is utilised by hospitals, emergency care centres, telemedicine companies, and other clinics. Teleradiology services enable radiologists to use online services in order to improve patient care and treatment without the need to be physically present on site. The global teleradiology services market is estimated to reach a market valuation of US$ 1,971.4 Mn by the end of 2016 and register a CAGR of 21.0% over the forecast period (2016–2026).

Increasing incidence of cancer, orthopaedic diseases, and other chronic diseases likely to boost market growth

Growth of the global teleradiology services market is mainly driven by growing incidence of chronic diseases such as cancer, tumours, and orthopaedic diseases; increasing geriatric population; and excessive hospitalisations and increasing admittance in ambulatory surgical centres and clinics. Increasing consumer awareness regarding teleradiology and easy accessibility to the technology is another key factor likely to drive the global demand for teleradiology services.

However, high cost of technology and services, image transmission issues, dearth of trained radiologists and technicians, and a low awareness in emerging economies is likely to pose major challenges for the growth of the global teleradiology services market.

By Process Type

• Certified Reporting Services Process
• Preliminary Reporting

By Service Type

• Emergency Nighthawk
• Day Time Coverage
• Subspecialty Reading
• Cardiac imaging
• Neuroradiology
• Nuclear scans
• Musculoskeletal studies
• Second Opinion
• Clinical Trails

By Modality

• X-Ray Scans
• Computerised Tomograph (CT) Scans
• MRI Scans
• Ultrasound Scans
• Nuclear Scans
• Cardiac Echo
• Mammography
• Electromammography

By End User

• Hospital Pharmacies
• Clinics
• Ambulatory Surgical Centres
• Radiology Centres

By Region

• US
• OUS (International)
• Latin America
• EU5
• Rest of Europe
• Japan
• Asia Pacific Excluding Japan
• Rest of the World

Certified Reporting Services Process segment likely to dominate the global teleradiology services market through 2026

The Certified Reporting Services Process segment dominated the global market in terms of revenue in 2015 and is expected to retain its dominance throughout the forecast period. The Preliminary Reporting segment is anticipated to be the second most lucrative segment in the global teleradiology services market.

Emergency Nighthawk service type segment expected to dominate the global teleradiology services market in revenue terms

The Emergency Nighthawk segment is anticipated to register the fastest CAGR over the forecast period. The Day Time Coverage segment is expected to be the second most lucrative segment in the global teleradiology services market.

Computerised Tomography (CT) Scans modality segment to retain its dominance between 2016 and 2026

The CT Scans segment dominated the global teleradiology services market in 2015 and is projected to remain dominant throughout the forecast period. The X-Ray Scans segment is expected to be the second most lucrative market segment.

Hospital Pharmacies end user segment anticipated to be the most attractive segment in the global teleradiology services market

The Hospital Pharmacies segment currently accounts for the highest revenue share in the global teleradiology services market due to an increasing usage of teleradiology services in hospital ICU and CCU. The Clinics segment is expected to be the second most lucrative segment in the global teleradiology services market.

U.S most attractive regional market for teleradiology services

U.S. dominated the global teleradiology services market in terms of revenue in 2015 and is likely to emerge as the most attractive regional market. The EU5 region is projected to be the second most lucrative regional market.

The global teleradiology services market is consolidated with key players occupying a major market share

The global teleradiology services market is largely consolidated, with top players accounting for a major market value share in 2015. Some of the leading companies operating in the global teleradiology services market are Teleradiology Solutions, Argus Radiology, SRL Diagnostics, USARAD Holdings Inc., Vital Radiology Services, Teleradiology Providers, Telemedicine Clinic, TeleDiagnosys Services Pvt. Ltd, Imaging Advantage, Foundation Radiology Group, Direct Radiology, Imaging On Call LLC, ONRAD Inc., Rays (Envision Healthcare Company), StatRad LLC, ARIS Radiology, NightShift Radiology, Mednax Inc., National Diagnostic Imaging, Alta Vista TeleRadiology, and Quality Nighthawk. These established players are focused on strategic moves such as new product launches, increasing their distribution channels, and getting into partnerships and agreements with hospitals and specialty clinics to increase the brand awareness of their product.

Social Media Promotes Use Of Teleradiology By Syrian Physicians
06/20/18
Social media has helped connect teleradiologists from around the world to the few physicians and imaging providers practicing in war-torn Syria, according to a study published May 31 in the Journal of the American College of Radiology. Since the beginning of the Syrian Civil War in 2011, 485 medical facilities have been bombed and 841 medical personnel have been killed, wrote Abdulrahman Masrani, MD, from the Mallinckrodt Institute of Radiology at Washington University in St. Louis, and colleagues. “The unique conflict … has disrupted every aspect of the Syrians’ lives,” the authors wrote. “It tremendously impacted the healthcare system with several reports of selective targeting of medical facilities and personnel.” Teleradiology interventions have been established to address a staggering number of casualties and traumatic injuries due to the conflict. Ghouta, a suburb located nine miles east of Damascus, has the highest death toll of medical personnel in Syria to date, wrote Masrani et al. The city’s population dropped from 1.2 million to 400,000 people since a siege began 2013. Some imaging equipment exists in Syrian field hospitals, including a few portable ultrasound machines, radiography machines, one functioning four-slice CT scanner and a dysfunctional CT scanner with confined field of view that is only used in select emergency cases, the authors wrote. However, they all lack MRI scanners and PACS, which has forced the only two radiologists to read directly from the scanner. This shortage of on-site radiologists pushed the Syrian American Medical Society to establish the Teleradiology Relief Group (TRG) in February 2015, according to the authors. The TRG is comprised of four volunteer radiologists and two volunteer radiology residents. The group provides 24/7 coverage of imaging examinations through secret social media groups only accessible through mobile devices. “Free and user-friendly social media platforms are feasible to utilize in providing humanitarian teleradiology services to areas under siege,” the authors wrote. “Notwithstanding the limitations related to the siege, such projects are valuable in providing expert interpretation of CT, radiography and ultrasound examinations.”  Using a satellite internet service, local doctors post to the Facebook group about their patients’ cases, medical images and lab results, if possible, the authors explained. The TRG teleradiology resident then comments on the post, providing an initial report and the attending radiologist approves it or not. Since being established in 2015, the TRG has interpreted 497 radiological examinations, including 374 CTs, 199 plain films and four ultrasounds. Due to shortage of extremely experience contrast, 97 percent of CT scans were done without contrast.  “Even contrast-enhanced CT scans were of low diagnostic yield because of the poor-quality scanners, improper timing of intravenous administration, poor protocol and acquisition parameters, and lack of qualified technicians,” according to the authors. “Repeating an examination was challenging because of the need for patient transport from the field hospital to the CT scanner facility.”  Medical images are sent using DICOM format 57 percent of the time, and 43 percent of examinations were sent using JPEG format.  “Interpretation of JPEG images was difficult because of the inability to modify the window or level and the lack of proper sequence,” the authors wrote. “In some instances, submitted images were taken by cell phone camera capturing poorly projected radiographic films or printed CT images on viewing boxes.” Nevertheless, preliminary reports are made within 24 hours after initially posting the exam in almost 90 percent of cases.

How One Michigan Provider Used Teleradiology To Boost Productivity And Slash Costs
06/20/18
At Radiology Imaging Solutions, the cost per study has been cut by more than 70 percent, productivity has increased by 400 percent, and report turnaround time has decreased by more than 50 percent thanks to health IT. At Michigan-based Radiology Imaging Solutions, a normal day starts around 7:30 a.m., when the radiologist assigned to teleradiology duties cleans up any studies that arrived after the normal workday had ended the day before. Since the group reads for hospitals and the teleradiology service, there are always studies to be examined. This allows the radiologist on teleradiology duty to read whatever is on the worklist for teleradiology and then switch over to some of the hospital work. The radiologist will cycle back and forth between teleradiology and hospital work every two hours. This keeps both worklists current. The radiologist assigned to the later shift will read all the studies that are on the worklist before leaving, usually by 6 p.m. Teleradiology, the electronic transmission of radiological images such as X-rays, CT scans and MRIs, is a booming business and was one of the first big use-cases for telemedicine. There are many vendors marketing teleradiology technology and services today, including Konica Minolta, NexxRad, OnePacs, RamSoft, StatRad and TelRadSol. “Without technology, none of this happens,” said Randy Robinson, owner of Radiology Imaging Solutions, which uses Konica Minolta’s tool. “When we first started offering our services, it would take 10 minutes to send a chest study into our PACS, then another 10 minutes to send to the radiologist workstation.” Robinson continued that it can conduct the same transaction in less than a minute. The radiology/teleradiology system enables customization, including worklists, hanging protocols, relevant priors, report templates and report delivery options, among other things. Radiology Imaging Solutions has doubled the number of imaging sites for which its radiologists are providing reading services. “It is mostly a matter of ROI,” Robinson explained. “Our old system required that we install expensive ‘gateway’ stations. This resulted in not only pretty significant startup costs, but also the ongoing support cost of software and hardware was suffocating. To recoup those costs, our fee per service had to be at a certain level, and the facility’s imaging volume had to be above a minimum level.” Radiology Imaging Solutions no longer needs expensive “gateways,” no longer pays software support on dozens of stations, and no longer needs to support dozens of hardware platforms that constantly fail, Robinson added. “In fact, we estimate that our teleradiology cost per study has been cut by more than 70 percent,” he said. “This allows us to offer our teleradiology services to lower volume facilities at very competitive fees, which means more facilities that we can provide teleradiology services to.” And by implementing the voice recognition component of the system in place of traditional transcriptionists, productivity has increased by 400 percent, with radiologists reading two-and-a-half times the number of studies with no corresponding increase in working hours and decreasing report turnaround time by more than 50 percent.

On-Site Radiology and Interpretation Services
06/19/18
NDI provides on-site radiologic services and information technology integration upon request.  Our IT staff is available to assist imaging centers and health care facilities at their physical location. Our technicians can help with PACS and RIS integration and use.   We provide remote and on-site technology consultations, robust data archiving, imaging protocol assistance and medical imaging accreditation support. We exchange information with our customers quickly for ‘STAT Reads” and when we discover critical results and findings.  The radiologists at NDI can perform both preliminary and final interpretations on-site. We also specialize in handling preliminary night interpretations.

Teleradiology Provider Reports 400% Increase in Radiologist Productivity while Simultaneously Increasing the Number of Studies Read by 250% after Implementing Exa PACS/RIS
06/15/18
Nine months after the implementation of Exa PACS from Konica Minolta Healthcare Americas, Inc., Radiology Imaging Solutions, a Grand Rapids, Michigan-based teleradiology provider and one of the state’s largest radiology imaging suppliers, has significantly increased volume and productivity, generating a significant return on its healthcare IT investment. The company has doubled the number of imaging sites its radiologists are providing reading services for. By implementing Exa’s Voice Recognition in place of traditional transcriptionists, their productivity has also increased by 400%. Radiologists are reading 2.5x the number of studies with no corresponding increase in working hours and decreasing report turn-around-times (TATs) by over 50%. “With Exa, we found a product that delivered more than we had expected in terms of cost-effectiveness and return on our investment,” says Randy Robinson, owner, Radiology Imaging Solutions. “It delivers a top-class software environment with affordable pricing—almost unheard of in our industry—and is a great product, with great people, who stand behind it. With Exa, Konica Minolta not only delivered every bit of what was promised but much more than that with advanced technology, service and support.” Exa utilizes Server-Side Rendering for fast access to large files, such as 3D Mammography, with no prefetching required and a diagnostic-quality Zero Footprint Universal Viewer for DICOM and non-DICOM images, including nuclear medicine and echocardiograms. According to Robinson, these technologies have helped reduce overall costs by avoiding the need to purchase dedicated workstations and has led to a reduction in reading times from an average of 4-5 minutes down to 1 minute.  In addition to increased productivity and reduced report TATs, Robinson believes that the use of Exa’s Voice Recognition module is also enhancing the quality of the reports and reducing radiologists’ fatigue and stress. Not only are the radiologists more satisfied with their job, they have also indicated they could further increase volume. In 2017, Radiology Imaging Solutions’ radiologists read and reported 35,000 diagnostic imaging studies. “Once we replaced our old PACS with Exa, our radiologists said they could triple their workload and not be overworked,” Robinson adds. “That’s how much faster, simpler and convenient this solution is over other systems they have used. What might take two to three clicks to read a study on another system, with Exa it is one click and the study opens with their hanging protocols.” In addition to teleradiology services, Radiology Imaging Solutions is also a dealer for Exa. Robinson shares that one customer—a Michigan healthcare provider—also implemented Exa Enterprise Imaging and its patient portal in 2017. Prior to Exa, only seven of the health system’s nearly 500 clinicians were accessing the prior systems’ portal for image viewing and sharing. Now, nearly all—490 clinicians across multiple specialties—are using it to access patient images and records. Exa Enterprise Imaging is also being utilized to store a multitude of images—from ophthalmology to dental to diagnostic imaging, including cardiac. Robinson estimates his customer will realize significant costs savings—potentially in the millions—by centralizing all imaging and enabling remote viewing and sharing of patient data. “As a dealer, I can tell my customers that dollar for dollar, there is no better PACS than Exa. And I know this because I not only sell Exa PACS, we use it every day in our teleradiology business,” Robinson says. About Konica Minolta Healthcare Americas, Inc. Konica Minolta Healthcare is a world-class provider and market leader in medical diagnostic imaging and healthcare information technology. With over 75 years of endless innovation, Konica Minolta is globally recognized as a leader providing cutting-edge technologies and comprehensive support aimed at providing real solutions to meet customer’s needs and helping make better decisions sooner.

The Teleradiologist Experience
06/15/18
If you’re a teleradiologist, your physical location doesn’t matter. Have secure network and proper equipment, ability to read and diagnose. When teleradiology first entered the industry as a career option, it was pigeon-holed into being an overnight service only. Radiology practices used teleradiology as a way to avoid overnight call. However, in recent years, reading images remotely has ballooned as a viable career option for radiologists who simply don’t want to work in hospitals or imaging centers. And, the teleradiology track is growing dramatically. According to a recent report from the market research firm Grand View Research, teleradiology is on pace to be a $8.24-billion business by 2024. Currently, X-ray reads account for 30% of the work volume, and CT scans are expected to grow annually by 20% through 2024. Clearly, working remotely is becoming a more popular option for new and experienced radiologists who don’t want to be tied to a set schedule or office. In some regards, especially with ease of access and communication with referring physicians, teleradiology mimics academic and private practice. It does, though, offer many differences, present significant benefits, and introduce substantial challenges. Still, said Michael Rothman, MD, a teleradiologist based in Bethlehem, PA, teleradiology fulfills a need within the radiology and patient community. “Teleradiology enables me and my colleagues to offer subspecialty coverage and technical training to providers,” he said. “We’re able to provide care to outlying communities so they don’t have to leave their locations to get the same quality of services as they would at larger facilities.”

As a provider, though, there are things you should know before you opt to work remotely as a diagnostic radiologist, he said.

Benefits

Choosing teleradiology has become a more viable career option over the past decade, said Michael Yuz, MD, an executive radiologist with USARAD, a radiology-on-demand company. As the opportunities have expanded, so have the positives that come with the work.

• Flexibility: As a teleradiologist, Yuz said, you’ll be able to set your down days and hours for work. Getting up early or working later are viable options that you can’t choose if you work in a brick-and-mortar 9-to-5 imaging center. “Don’t be fooled into thinking you won’t work as much, though,” he said. “You’ll likely actually work more hours than your colleagues in centers or hospitals. It’s not uncommon to work twice as much – to mostly have 12-to-14 hour days.”
• Lifestyle: If you aren’t tied to an imaging center, you’re freer to choose where you live, and you’ll have more time to interact with your friends and family, Rothman said. If you’re happier where you live and work, you’ll experience less stress in your work life, as well.
• Subspecialization: Most imaging centers tend to ask their radiologists to be generalists. If you’re a teleradiologist, you have more opportunities to focus on a subspecialty, Yuz said. “Though, you might be expected to be knowledgeable in all areas, there are opportunities to subspecialize,” he said. “You also have the opportunity to stop in and read for hospital radiologists who don’t have the experience in your area of expertise.”
• Choose Your Partners: As a teleradiologist, you can be more selective about the imaging centers and hospitals with whom you partner. It’s up to you to decide whether you’d like to work with larger or smaller entities, Rothman said.

Challenges

But, alongside the benefits that come with working remotely, you will encounter challenges to your daily practice, Rothman said.

• Absence: You might be working around the clock from your home or vacation site, but your hospital administrators or practice leaders don’t know that. You’re not there for face-to-face conversations, so that can put you at risk. “As the teleradiologist, I’m the easiest target for cuts because I’m not part of the hospital groups or network for insurance billing,” he said. “They can pick me up and replace me easily.”
• Economic Downturns: There’s nothing you can do to control this problem, Rothman said. When the economy stumbles, hospitals and imaging centers become more frugal, pulling back on expenditures. That means there’s less cash to invest in the remote reading services you offer.
• Technology: Again, you’re at the mercy of uncontrollable forces with technology. If your computer or network experiences a glitch, you could find yourself unable to work for an undetermined amount of time. Depending on what your contracts stipulate, Rothman said, you could find yourself unable to meet your professional obligations. “As teleradiologists, we have to accept that we’re dependent upon electronics,” he said. “But, to do what we do, you have to have 24/7/365 technical support.”

Payment & Reimbursement

Getting paid as a teleradiologist is different from collecting a paycheck from a hospital or imaging center, Yuz said. Despite its reputation, teleradiology doesn’t require less work for more money. In fact, he said, the opposite is true. In this role, you’ll read more for the same or less pay. Typically, teleradiologists make less than radiologists who work on-site. The difference comes from reimbursement strategies, Rothman said. When teleradiologists contract with imaging centers or hospitals, they sign over their rights to file reimbursement on their own behalf – the hospital or imaging center files for them. Consequently, any reimbursement paid for teleradiology services gets diluted in the cash flow used to pay for the practice’s working expenses. In general, he added, you’ll likely be paid in one of two ways – either as salaried, plus bonus, or on a per-click basis, meaning the more you read, they more you get paid. Yuz agreed, adding that you have to not only be fast, but you must also be accurate in your reads. “If you don’t read well with a low error rate,” Yuz said, “you won’t do well in teleradiology.”

What You Should Know
If you’re considering teleradiology as a career, there are some things you should think about, Yuz and Rothman said. If you can work within these parameters, teleradiology could be a good career choice.

• Self-motivation: If you work remotely, there’s no one watching over you to ensure you’re reading images when you say you’ll be. You must be able avoid the distractions – whether they’re family or household chores – that pop up from working at home.
• HIPAA: Having a dedicated, at-home office space isn’t enough to be a practicing teleradiologist. You must be sure you have a HIPAA-secured network so you’re protecting patient data at all times.
• Legal Support: Chances are, you’re working with practices and hospitals that are scattered throughout the country – or internationally. You’ll be required to have licenses to practice in all states, and you’ll need legal representation in each state to ensure your liabilities are covered.
• Personal Contact: Before you opt for teleradiology, honestly assess whether you enjoy face-to-face contact with your referring physicians, Yuz said. If you enjoy meeting with colleagues and having in-person interactions frequently, it’s unlikely you’ll be happy with teleradiology.
• Speed: Are you fast? Can you read accurately and rapidly? If so, teleradiology could be a good fit. However, if you need to work a little more slowly, you may want to consider working in an office environment. Ultimately, both Yuz and Rothman agreed, as teleradiology continues to grow and more facilities rely on it for greater subspecialization and timely diagnoses, it’s likely more radiologists will choose working remotely over tying themselves to a facility on a daily basis. “You can create a lifestyle that meets your needs and still provides you with a reasonable income stream and quality cases with great groups to work with,” Rothman said.

Choosing a Teleradiology Company
06/13/18
An ideal teleradiology company should be available 24/7. Try to find a teleradiology company that lets your staff talk to reading radiologists whenever they want to discuss important questions and critical results and findings. Contract with a teleradiology company that only employees radiologists certified by the American Board of Radiology (ABR). Absorb emerging trends in the field of teleradiology.

Radiology Today Magazine
06/11/18
The magazine reaches 40000 radiology professionals nationwide on a monthly basis. The publication addresses radiology and medical imaging industry professionals’ issues, difficulties and shared interests.  Radiology Today reports on the latest news and information affecting the radiology industry.  Subscribe to the magazine.

Imaging Technology News Magazine
06/11/18
ITN reaches more than 34,000 radiology, radiation oncology, women’s health and nuclear medicine professionals. Subscribe to the magazine.

RadiologyBusiness.com
06/11/18
Radiology Business Journal, Radiology Business News (daily enewsletter) and RadiologyBusiness.com covers all matters related to medical imaging, with a particularly keen focus on fiscal, managerial and other economics-specific angles.

Radiological Society of North America Annual Meeting
06/11/18
The RSNA’s annual meeting will take place November 25 to 30 at McCormick Place in Chicago.  Learn from the best and the brightest.

How to Start a Mobile Ultrasound Company
06/11/18
Running a profitable mobile ultrasound service begins with the challenges faced during the start-up process. Become a sponge for industry knowledge. Get your financing squared away. Choose your business structure. Acquire equipment to operate your mobile ultrasound company. And finally, get some clients.

Consolidation and Change: The Current State of Outpatient Imaging
06/11/18
Large outpatient medical imaging services are trying to keep up but some of the smaller imaging centers are struggling to stay in business. Reimbursement issues are creating challenges, financial pressures and strong competition from hospitals are also pressuring outpatient imaging clinics. As a result, consolidation of imaging centers is happening.