Teleradiology paves way for remote medicine

By Kavita Chandran – Reuters
http://www.washingtonpost.com

BANGALORE (Reuters) – On a computer monitor in his office in the high-tech hub of Bangalore, Indian radiologist Arjun Kalyanpur examines a scan of the skull of a six-year-old boy who fell off his bicycle.

A few minutes later, thousands of miles away, doctors at a hospital in Philadelphia prepare the boy for surgery after receiving an urgent email from Kalyanpur diagnosing a subdural hemorrhage in the child’s brain.

It’s the middle of the night in the United States, but it’s daytime in Bangalore and Kalyanpur and his team of 35 radiologists are reading hundreds of scans sent by hospitals across the United States during the night shift.

“ERs in the U.S. find it difficult to staff at night. There’s a radiologist shortage in the U.S. as well,” Kalyanpur told Reuters.

Bangalore, the outsourcing capital of the world, is becoming a global center for telemedicine thanks to a pool of Western educated doctors, extensive outsourcing infrastructure, lower costs and a convenient time zone to diagnose medical conditions during the U.S. night.

Teleradiologists in India read x-rays, CT scans, MRIs and other medical images of patients in the United States, Singapore and a host of other countries around the world.

It’s ideal for hospitals facing ballooning costs and a shortage of radiologists. And it’s not just teleradiology, experts say just about every area of medicine that does not require direct patient interaction could be outsourced in the future.

This could include scans of pathology samples, ECGs, EEGs and other diagnostic systems used to determine a preliminary diagnosis.

“Telemedicine is on the rise,” said Avinash Vashistha, the CEO of Tholon Inc, a private equity advisory firm, who has written a book about outsourcing.

“Once it acquires critical mass in 2 to 3 years, we expect the thrust to come from insurance companies as they recognize the cost benefits and lower premiums for the plans that have components of telemedicine.”

There are some concerns, though, that it might lead to dangerous misdiagnosis and even those in the industry admit that regulation hasn’t caught up with technology when it comes to medical malpractice, ethics and legal liability.

Liability, privacy and malpractice issues pose challenges as this new industry expands without a supporting international regulatory framework as well as an ethical code of conduct.

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