Cloud and AI are key to teleradiology success in post-COVID resurgence, expert says
To find out what is new in radiology IT systems, Amy Thompson, research manager for healthcare IT at the healthcare market analysis firm Signify Research, spoke with Health Imaging at the Radiological Society of North America (RSNA) 2023 meeting. She shared some key observations based on her discussions with vendors.
Cloud and AI adoption helps streamline radiology workflows
In the interview, Thompson highlighted a noticeable shift towards cloud adoption and the development of more cloud-native architectures in radiology informatics systems. Vendors are gradually implementing phased approaches, emphasizing the importance of managing a disparate teleradiology network of radiologists efficiently. Cloud technology, coupled with AI, has become crucial in meeting and maintaining service level agreements (SLAs) with healthcare providers.
"RSNA is a really great show to start seeing more progress towards cloud adoption and more cloud native architecture. A lot of these bigger, longer-term trends are more iterative stages for vendors. So there are not necessarily big, bold out-of-the-blue announcements that take me aback and go, okay, I wasn't necessarily expecting that. They're more so these phase approaches towards achieving these long-term goals." Thompson said.
The global healthcare workforce crisis has prompted a strategic approach in teleradiology, not only as a response to the crisis, but also as a retention strategy. Thompson emphasized that offering a more innovative and streamlined technological solution can make the field more attractive to radiologists, contributing to both recruitment and retention efforts.
Post-COVID resurgence of teleradiology
Contrary to expectations, teleradiology experienced a dip during the COVID-19 pandemic due to the pause in procedures and non-essential exams, and the slow reboot of the health systems over 2021 and 2022. However, as healthcare systems recover, teleradiology volumes are not only returning to pre-COVID levels but also surpassing them because of the backlog of exams and procedures. Thompson said, outsourcing, especially to imaging centers and radiology reading groups, is becoming more prominent as healthcare providers grapple with managing procedural backlogs and other market pressures.
"Healthcare systems are struggling with managing everything on their radar whilst dealing with financial pressures, inflation and the workforce crisis. So that's where outsourcing is becoming more prominent within the market," Thompson explained.
Retail clinics and imaging centers are also becoming more prominent post-COVID.
"In the U.S., you're seeing quite a big kind of push, more so on primary care from the Walgreens and the Walmarts, but on the Walmart side, you're also seeing that diagnostic imaging strategy come into that. So looking at offering X-rays and ECGs within the Walmart setting in the clinics," she said.
Radiology IT and teleradiology vendors see this as an opportunity because their core markets are very saturated.
"For teleradiology, this is an emerging segment. Same with imaging centers where vendors are now looking at how they might adapt solution and leverage more technology for maybe a lighter footprint. Some of them are private equity backed, so they've got a bit more money to invest on that efficiency side," Thompson explained.
Teleradiology service growth world-wide
Teleradiology services remain crucial for managing off-hours, evenings, and weekend work, with providers adapting to handle increasing workloads. While some countries impose legislative restrictions on teleradiology use to keep work within hospitals, its global adoption is a growing trend. Thompson highlighted the rise of international collaboration, particularly in developing countries, providing opportunities for Western physicians to remotely read exams and enhance access to quality care.
"It can be quite difficult, depending on which countries want to couple with which, because you have certain regulations or qualifications that you might need to be certified to read for a certain country. But we are seeing it increasingly so with the U.K. and Australia, obviously on opposite sides of the world. We are seeing this even more so in emerging markets like India. Even in just more rural populations or where accessibility to care is very low due to the infrastructure of healthcare at this moment in time, teleradiology can play a very significant role in improving the quality of care to patients," explained Thompson.
However, she noted that the international teleradiology market is highly fragmented, with numerous small providers emerging. In most instances, infrastructure poses a significant challenge, making it difficult to promote remote reading capabilities that match the quality found in most Western countries.
"And you'll see sometimes countries, whether or not that's Japanese radiology providers looking to read in China or other Asian countries, or you've got India looking to read studies in the U.S. So they are looking at where they can expand and collaborate. But you've also got language barriers and everything else. Even when you look in the country of India, because it is so large, you've got different dialects. So again, you limit necessarily where you can expand or work with. That's also where we're starting to see potentially some partnerships," Thompson explained.
Some teleradiology firms are exploring collaborative efforts with companies from different countries or with IT vendors. Thompson stated that this approach might provide better teleradiology services locally and offer a comprehensive end-to-end solution. This trend is observed in the Middle East, such as the Saudi Arabian government's recent initiative to establish a national teleradiology program.
AI adoption in teleradiology
The integration of AI in teleradiology is becoming increasingly prevalent, with top and bottom-end markets showing interest. Academic institutions and imaging centers are at the forefront of AI adoption, but partnerships between AI vendors and teleradiology providers are growing. Efficiency gains and the potential for competitive advantages are driving investments in AI technology, even in the absence of immediate reimbursement.
"Another big trend within the world at teleradiology is AI adoption increasingly seen in the mainstream hospital segment. We are seeing an increasing amount of deals and AI vendors announcing partnerships with teleradiology providers. When you are looking at the efficiency gains, that is one of the more critical markets that need it because the teleradiology providers see it as an opportunity to stand up competitively against the others," Thompson explained.
She said AI can help reduce the time to read studies and can optimize their triaging and prioritization of studies in wordlists, which can be a strong ROI motivator to invest in the technology.