Results of an Italian survey on teleradiology

Abstract

Objectives

The aim of this study is to present the results of the Italian survey on teleradiology (TR).

Methods

Two radiologists created an online electronic survey using the Survey Monkey web-based tool. The questionnaire was then improved by suggestions from a multidisciplinary group of experts. In its final form, the survey consisted of 19 multiple-choice questions. Space was left below each question for participants to add their personal comments. Members of Italian Society of Medical Radiology (SIRM) were given 2 weeks to perform the survey.

Results

A total of 1599 radiologists, corresponding to 17 % of all SIRM radiologists, participated into the online survey. As a result, 62 % of participants have a positive opinion on teleradiology, while 80 % including 18 % with a negative opinion believe that teleradiology will have a future. 55 % of responders (n = 874) use teleradiology in their clinical practice. The majority of users adopt intra-mural teleradiology for coverage of emergencies (47 %), of night and weekend shifts (37 %) or to even out distribution workload (33 %). Most responders still show concern on the use of teleradiology. In particular, they think that teleradiology is too impersonal (40 %), and that it is responsible for insufficient communication with the referring clinician (39 %).

Conclusions

The majority of Italian radiologists are favorable to teleradiology. However, they have concerns that teleradiology may further reduce communication with the referring clinician ad patient.

Appendix

Appendix shows all 19 questions with answers of the survey

1. In which region do you work?
Abruzzo	1.89 %
Basilicata	0.50 %
Calabria	3.09 %
Campania	6.80 %
Emilia Romagna	9.76 %
Friuli Venezia Giulia	2.02 %
Lazio	12.47 %
Liguria	3.90 %
Lombardia	15.99 %
Marche	2.77 %
Molise	0.38 %
Piemonte	5.73 %
Puglia	6.49 %
Sardegna	1.89 %
Sicilia	7.43 %
Toscana	8.82 %
Trentino Alto Adige	1.51 %
Umbria	1.57 %
Valle d’Aosta	0.44 %
Veneto	6.55 %

2. What age group do you belong in?
25–35 years old	16.96 %
36–45 years old	22.09 %
46–55 years old	25.76 %
56–65 years old	30.82 %
Over 65	4.37 %

3. What is the site of your main professional activity?
Public hospital	64.35 %
Private hospital	10.19 %
University hospital	12.06 %
Research institute	2.26 %
Private diagnostic centre	11.15 %

4. What is your professional degree?
Radiology resident	7.95 %
Consultant radiologist self employed (libero professionista)	15.70 %
Radiologist with fixed term managerial position (incarico dirigenziale a tempo determinato)	6.16 %
Radiologist with basic managerial position (incarico dirigenziale di natura professionale di base)	28.87 %
Radiologist with managerial position with high specialization (incarico dirigenziale di natura professionale elevate)	13.05 %
Radiologist director of simple unit (incarico di direzione di struttura semplice)	11.72 %
Radiologist director of complex unit (incarico di direzione di struttura complessa)	13.51 %
University researcher	0.86 %
Professor associate (professore associato)	0.99 %
Professor (professore ordinario)	1.19 %

5. Do you use digital signature in your Institute?
Yes	65.38 %
No	32.02 %
Occasionally	2.60 %

6. How are radiological images stored in your Institute?
On a analog archive	5.73 %
Each diagnostic modality has its own archive	5.02 %
On a PACS system	17.64 %
On PACS of the Department	48.16 %
On PACS of 2 or more health facilities	23.05 %
On PACS; Images and clinical data are accessible from electronic health records	8.11 %

7. Where do you usually use Teleradiology?
I don’t use teleradiology (if you answer yes go directly to question 15)	45.26 %
Within hospital on a dedicated workstation	47.52 %
At home	8.83 %
Everywhere using a mobile	5.93 %

8. Which application do you use for Teleradiology?
Same application utilized for other radiological activities	87.40 %
‘Stand alone’ application only for teleradiological activities	8.21 %
‘Add on’ application of reporting system with specific added functions	4.39 %

9. What are the reasons of the use of teleradiology? (Table 2)
For reporting of examinations performed in the company where I work (remote management procedures of intra-company deferrable urgent/emergency)	47.32 %
For reporting of examinations performed in the facility where I work (remote management procedures intra hospital)	33.26 %
As part of regular workflow in the institute where I work (outsourcing)	12.28 %
For a second or expert opinion from a colleague with another sub-specialty	21.65 %
For a second opinion from a colleague with a different specialty (for example a neurosurgeon)	15.96 %
For online multidisciplinary meetings	4.91 %
On a temporary basis (staff shortages, holidays and illness)	6.70 %
For night and week-end coverage	37.28 %
For double reading (for example mammography)	7.03 %
For research or teaching purposes	5.25 %
Other	8.82 %

10. What are the disciplines for which is required a second opinion in your Institute?
We receive second opinion requests for every kind of examination	24.37 %
Neuroradiological consults	17.05 %
For pediatric examinations	4.23 %
For evaluation of interventional procedures	13.04 %
In out Institute we do not receive second opinion requests	48.74 %
Other	6.52 %

11. What are the disciplines for which do you usually ask a second opinion?
We ask a second opinion for every kind of examination if particulary complicated	17.94 %
For neuroradiological examination	30.21 %
For pediatric examination	4.63 %
For evaluation of interventional procedures	7.99 %
We don’t ask second opinions to other Institute	51.39 %

12. How do you usually receive patient’s clinical informations?
By telephone	26.78 %
By fax	7.82 %
By e mail	4.37 %
By instant messaging software (ex. Viber, Whatsapp)	1.03 %
By direct connection with RIS	52.64 %
Utilizing a dedicated platforms	7.36 %

13. How do you usually send the examination’s report?
By telephone	4.30 %
By fax	5.58 %
By e mail	6.28 %
By instant messaging software (ex. Viber, Whatsapp)	0.58 %
By direct connection with RIS	74.77 %
Utilizing a dedicated platforms	8.49 %

18. In conclusion do you think that teleradiology could be an advantage or a disadvantage for radiologist?
Yes, I am enthusiastic, I think that teleradiology could be an advantage for radiologist	10.03 %
Yes, I am generally favorable	51.86 %
No, I am generally unfavorable	18.31 %
No, I am absolutely unfavorable, I think that teleradiology is a disadvantage for radiologist	11.53 %
I don’t know, I am not convinced	8.27 %

19. Do you think that teleradiology could have a future?
Absolutely not	2.08 %
No	3.89 %
I don’t know	14.01 %
Yes	58.63 %
Absolutely yes	21.40 %