Comparison of After-Hours Computed Tomography Utilisation Between Teleradiology and On-Site Reporting Models in a Regional Hospital.

INTRODUCTION

Teleradiology services are increasingly being used to cover growing after-hours computed tomography (CT) demand. It is unclear if this is associated with increased CT utilisation due to reduced radiologist oversight of imaging requests.

METHOD: 7, 120 consecutive evening and weekend CT examinations performed over a 17-month period at a single 350-bed New Zealand hospital were used to calculate both the mean number of CT examinations per hour and the mean study attributable time (SAT) per hour for both teleradiology and on-site radiology coverage. The teleradiology service provided reporting services but did not vet or protocol requests (this was determined by the requesting clinician).

RESULTS

Teleradiology coverage was associated with an increased number of after-hours CT examinations per hour compared with on-site radiology coverage (2.00 vs. 1.85 examinations, p = 0.02). A higher study attributable time for the teleradiology group was also found (23.6 vs. 21.6 min, p = 0.02). No statistically significant difference was identified for radiation-sensitive subgroups, although the number of examinations was small.

CONCLUSION

Teleradiology services were associated with greater emergency CT utilisation, hypothesised to be due to the lack of radiologist involvement in scan vetting and protocolling. These findings emphasise the role of the radiologist as a clinical advisor and collaborator in addition to the task of image interpretation. Further data from other centres and in radiation-sensitive populations would be useful to confirm if these findings generalise.