Prof. Johan G. Blickman
Chairman, Dept. of
UMC St. Radboud,
The Golden Rules: Guaranteeing Good
The new service environment or digital workplace will be cemented by:
'Co-operation between radiologists in different EU countries;
'Establishment of commercial agreements for consulting, providing, and sub-contracting services within the EU and with centres outside the EU;
'Differentiation between the physical spaces where radiological diagnostic examinations are performed and those in which the examinations are evaluated and reported on;
'Guaranteed service without territorial constraints, recognising the mobility of the population in the world today;
'Elimination of language barriers that limit the offer/purchase of services;
'Legal compatibility between interregional or trans-national services to ensure sharing, security, and confidentiality of data related to the healthcare process;
'Nudging the EU to not only establish but also enforce standards for training and maintaining competence.
In Europe, the advantages of teleradiology are different to those enjoyed in the US; off-hour service provision is not such an attraction, and also because the threat of malpractice is all but non-existent here. The real opportunity for teleradiology in Europe is the way it addresses the overflow phenomenon. Additionally, the growing EU has now incorporated members that have medical diagnostic levels nowhere near as large, modern and efficient as in the “Western” world. The benefits of teleradiology can be summarised as the timely interpretation of emergencies 24/7, from any location and any hospital, increased flexibility of radiologists, functioning as a virtual extra radiologist, sub- specialist interpretation options and new opportunities for continuing medical education.
Challenges to Come for Teleradiology in
How can we achieve this ‘utopian’ vision for the future of imaging services in Europe? Firstly, a number of practical issues need to be reviewed. Legal issues abound, particularly in the security and confidentiality realm, for example; guarding against misdiagnosis; the legality of having a digital signature on both request forms and the final report in all member states; secure licensing of the interpreting radiologist and training management; different legal structures in every European country; privacy issues, and data security while in transfer.
Also, there are varying levels of radiological training as well as experience with advanced modalities in Europe, and varying levels of standardisation and registration. This, contrary to the situation in the USA, does not allow for a universal standard of care with resultant levels of expectations between clinicians and radiologists. Other disadvantages include the fact that multiple languages exist in Europe that could lead to difficulties with interpretations of nuances and intent in any form of communication.