Today the world is enveloped in the Coronavirus pandemic that is growing in its extent. In this environment of fear and uncertainty, we can take reassurance from the fact that telemedicine technology is on our side to support our doctors in their efforts to identify and treat COVID-19. In particular, teleradiology has emerged as a key enabler in the battle against the coronavirus.

Teleradiology is the branch of telemedicine that has consistently been at its forefront. It involves the transmission of a patient’s scan images from the scanner where they have been acquired to the location where the radiologist is available. Right now doctors cannot always physically be present where the patient is either due to a lockdown as is in force in many parts of the world or due to them being in self-quarantine due to exposure to a patient with COVID. In such a situation, teleradiology has come to the rescue with doctors being able to read, albeit from afar, X-rays or CT scans of coronavirus patients.

Why is Radiology of importance in the Coronavirus pandemic:

Radiology has been found to be of significant value in the care of patients with Coronavirus. It has been seen that some radiologic patterns seen on X-ray and chest CT scan can be quite specific for COVID-19 infection.  In China at the early stages of the epidemic outbreak, before swab testing was readily available, CT scan was used by doctors to assess the probability of COVID-19 infection, and it has also been used to track and follow the progression of the disease, as described by some researchers from China. For this reason the ability to quickly report scans conducted on patients suspected to have COVID infection is of particular importance at this time.

How does Teleradiology help?

In the emergency setting, teleradiology ensures that when a scan is performed, it can be reported immediately and treatment decisions may be made right away.

In India we have a disproportionate number of radiologists based in metros, with relative under-representation in tier-2 cities and remote parts of the country. Therefore, even when the imaging equipment may be available, the radiologist may not be on site at the time of the xray or scan to report it. Teleradiology is of great value in this environment. Our reporting of xrays performed at Community Health Centres across the state of Tripura by our national panel of radiologists, is an example of such a scenario. In an environment such as the current COVID pandemic where large numbers of chest Xrays and CT scans are likely to being performed over a short time frame, teleradiology can be a valuable backup

Further, over the past two decades, teleradiology has extended internationally. In our organization a single radiologist can be reporting for multiple hospitals across the globe simultaneously, extending the reach and contribution of the radiologist far beyond their reporting room. In the setting of a global pandemic, having a panel of radiologists spread across the globe who can provide 24 x 7 coverage is a valuable backup for local systems that may be overwhelmed during a regional spike in cases. Especially during the night shift when staffing is short and staff are overworked the availability of a backup radiologist who is in a day-time zone across the world can be of major benefit.

Maintaining radiologist productivity during Social Distancing

A further important role of teleradiology at this time lies in ensuring continuity of patient care by allowing radiologists to work uninterrupted from their homes in a protected environment. While some radiologists will need to be present at the hospital to perform onsite procedures those who are in an interpretive role can report cases from offsite.

Teleradiology allows radiologists to work and be productive even when isolated from the rest of their community, which, during the need for social distancing as in the current epidemic, can definitely help restrict virus transmission. In the setting of quarantine/self-isolation it allows radiologists to continue to be productive and make a truly valuable contribution at the time of an unprecedented crisis.

Additionally, the use of teleradiology technology makes it possible to quickly and efficiently conduct training updates and educational activities within a large group of radiologists. For instance, radiologists have been trained within 24 hours on new guidelines which emerged from RSNA on March 26^th, 2020. Is this or is this not COVID pneumonia ?-a doctor reading or working in isolation may be unsure and need a second pair of eyes to help decide on the diagnosis. Teleradiology provides a virtual office type workflow which allows a team of radiologists to remain connected at all times for discussion of complex and doubtful cases.

Access to case material from around the globe:

As mentioned, radiology has already played a significant role in the COVID pandemic till date.  As the pandemic spreads across the globe, teleradiology gives radiologists the ability to extract imaging information from cases seen in one part of the world and utilize that experience to maximum benefit in others.

A support system when the world needs it

While teleradiology has established its role as a key player within healthcare in general over the last two decades, its role in the setting of the COVID-19 global pandemic is of equal if not greater importance.

At this time of this pandemic crisis, by supporting areas of physician shortage and backing up their in-hospital counterparts, Teleradiology can help in a significant manner to relieve some of the stresses that global healthcare systems are currently experiencing.