Effect of real-time teleradiology on the practice of the emergency department physician in a rural setting: Initial experience

The authors' goal was to determine the feasibility and usefulness of online teleradiology consultation for emergency department physicians at a rural hospital. Electronic linkage between the emergency department of Chatham County Regional Hospital (remote site) and the University of North Carolina Hospitals (host site) was established via a fiberoptic network. From October 1995 through September 1996, teleradiology consultation was initiated by an emergency department physician at the remote site and was provided online by host-site radiologists using a commercially available teleradiology system and a high-resolution digitizer. The turnaround time for each teleradiology consultation was calculated, and the effect of the consultation on diagnosis and treatment was assessed. The emergency department physicians scored their satisfaction and comfort levels with the system by using a scale of 1–7, with 7 representing the highest and 1 representing the lowest satisfaction and comfort. The online soft-copy interpretation was compared with a later interpretation of the original hard copy. A total of 123 separate studies comprising 460 radiographs were successfully transmitted in 90 discrete teleradiology events. The mean turnaround time for a teleradiology consultation was 1.3 hours. The teleradiology consultations led to changes in the emergency department physician's initial diagnosis in 27 of 90 cases (30%) and resulted in treatment changes in 23 of 90 cases (26%). The emergency department physicians reported an average satisfaction score of 5.4 and a comfort level of 5.6 with the teleradiology system. No major discrepancy between soft- and hard-copy interpretations was noted. Online real-time teleradiology consultation is feasible with available technology.