Outsourced teleradiology imaging services: an analysis of discordant interpretation in 124,870 cases

Outsourcing after-hours radiology coverage to a teleradiology coverage company has become common in recent years. However, concerns have been raised over the quality of these types of coverage and the implications on patient care. This study details the quality assurance program of a teleradiology company that provides after-hours coverage to 64 California hospitals.

The records of all examinations interpreted by 10 radiologists during 2003 were reviewed. Interpretations were compared with the final interpretations of the host practices and evaluated for timeliness.

A total of 124,870 radiologic studies were interpreted by 10 teleradiologists during 2003. Computed tomography (CT) comprised 74% of these examinations: CT head (35%) examinations were the most commonly transmitted examinations, and CT abdomen/pelvis examinations were the second most common studies (27%). The average turnaround time was 12.2 min; 93% of the examinations were reported within 30 min, and 99% were completed within 1 hour. The overall discordant rate for individual teleradiologists ranged from 0.70% to 1.41%, with an average of 1.09%. Of the most commonly ordered examinations, CT of the abdomen/pelvis had the highest rate of discordance, at 2.1%.

Outsourcing to a teleradiology program with an active quality-assurance program can be safe. An active quality-assurance program should be an integral component of any teleradiology program. Constant feedback improves the performance of the radiologists.