Teleradiology: part of a comprehensive telehealth system

Present technologic limitations do not allow completely accurate reproduction of a chest film, the gold standard of teleradiology. Although interpretation accuracy of broad-band teleradiographs is reasonably good and encouraging, the low level of confidence engendered by teleradiology interpretations in narrow-band transmission is self-evident in view of the tendency to provide an immediate provisional report followed later by a signed report after direct viewing of the film. Despite this, the important observation, putting things into perspective, was made by Andrus and Bird, namely that "the question is not whether teleradiology is preferable to direct visualization when either is available, but whether teleradiology offers an acceptable universally applicable method to augment the usefulness of the radiologist." Although fiberoptic guides may well lace the country in a few years, providing ample capacity and superb transmitted images, there are several options presently worth investigating now. These could provide teleradiology services to remote and rural communities, depending on the level of need and skills at the remote site, the availability and cost of transmission, and the need for access to 24-hour consultation services. The future role of teleradiology on a much larger scale within a regional network of health care facilities has yet to be defined, based on the perceived need for reasonable access to expensive but precise imaging methods. On the face of it, it would seem unlikely that small community hospitals will be able to afford the cost and maintenance of CT and MR scanners, digital angiography, and other useful and accepted imaging services.(ABSTRACT TRUNCATED AT 250 WORDS)