Evaluation of the Real-time Teleradiology Consultation System in the Emergency Department

Teleradiology involves the transmission of all radiological images to a radiologist in a remote location to ensure an accurate diagnosis. Although various teleradiology systems exist, there is not a fully accepted real-time interactive teleradiology system yet. In this study, we analyzed “the teleradiology consultation system which includes a real-time and instant messaging program (Skype®)” established in an emergency department. The consultations requested from the teleradiology system implemented in the emergency department (ED) of a Medical Faculty Training and Research Hospital were evaluated between January 2018 and June 2018 retrospectively. A total of 18,284 teleconsultations were included in the study. The mean age of the patients who required teleconsultation was 40.6 ± 24.8 years (range: 0–109 years) and 10,069 (55.1%) were male. And 17,079 (93.4%) computed tomography (CT) was consulted. The majority of CT scans were cranial CT (n = 7113, 41.6%) and upper-lower abdominal CT (n = 5436, 31.8%). And 1205 magnetic resonance imaging (MRIs) (6.6%) were consulted. The majority of MRIs were diffusion MRIs (n = 975, 80.9%). The mean evaluation time of radiological imaging was 66.3 minutes. In 7238 (39.6%) of all consultations, a problem or a demand was reported via interactive communication by radiologists or emergency physicians. They are as follows; the desire to speed up delayed reports (33.0%, n = 2388), problems related to radiological images (32.0%, n = 2316); demand for correction of delay problems from health system technicians (11.6%, n = 839), incomplete reporting (6.6%, n = 477), demand for the acceleration of reports of critical patients (6.4%, n = 463), request for re-evaluation of radiological images (5.2%, n = 376), the demand for additional clinical information of the radiology doctor (2.0%, n = 144), asking radiology doctor the statements in the report or to request for disclosure of findings (1.1%, n = 78), the other reasons (2.0%, n = 144). All of these problems were answered with real-time interviews and solved. Conclusion: The teleradiology system is important in health institutions where there is no 7/24 radiologist. This study showed that the establishment of a teleradiology consultation system integrated with a messaging service in the ED might provide real-time and immediate resolution of the occurring problems.