Teleradiology as a driver for regional-scale, multi-organizational, high-volume telehealth systems

Abstract

Many regions face a crucial shortage of radiologists, especially in rural areas. In 2001 the Navajo Area Indian Health Service issued an RFP for teleradiology services. The University of Arizona department of Radiology received the contract and worked with Navajo Area service units to create an effective teleradiology service while overcoming challenges of communications infrastructure and multiple organizational boundaries. Department personnel worked with Navajo Area to design and implement new high-speed communications infrastructure on Navajo lands to support teleradiology services. This deployment was completed in the Spring of 2002. Each Area service unit is essentially an independent organization and maintains separate information about patients. This creates a complex, multi-organizational information environment. The case volume for teleradiology, including three sites other than the Navajo Areas, is at approximately 2,000 cases per month. Teleradiology is a routine part of the work flow at the university and is increasingly becoming integrated into the work flow at the rural sites. We have found teleradiology to be extremely effective in addressing the problems of medically underserved areas. Multi-organizational operation presents challenges for electronic integration requiring collaboration from appropriate clinical and technical personnel. The multi-organizational factor also benefits from an evolutionary approach with gradually increasing integration.