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What can be done to save rural imaging?

por Valerie Dimond, Contributing Reporter | December 04, 2020
Business Affairs
From the November 2020 issue of HealthCare Business News magazine


Additionally, factors that disproportionately affect access to imaging in rural areas during this pandemic, to name a few, include: small staff size, which leaves little redundancy to compensate for sudden absences; fewer available public and/or affordable transportation options for communities that generally are less affluent and have to travel longer distances to receive their care; greater challenges in communicating important and timely care-related community and health matters due to (at times) inaccessible internet services or the inability to afford such services.

HCB News: Does it make sense to draw a line between X-ray and advanced imaging access? Is it fair to say that the challenges are primarily concerning exams like MR or PET/CT, for example?
EF: It's important to address the access-related issues related to all imaging modalities, as well as access to image-guided, minimally-invasive procedures — both emergent and non-emergent — ranging from vascular-related procedures to biopsies and drainages. All of these are important when considering the high impact they have been demonstrated to have on identifying and treating both disease and injuries. The "line" you refer to usually gets drawn because many more centers can provide x-ray and ultrasound services, but either cannot afford or cannot justify the more expensive and sophisticated technologies of MR, CT, PET, etc. Additionally, the more sophisticated capabilities require highly-trained staff and maintenance resources that may be hard to come by in rural America. The diminished access our rural communities have to these services tends to amplify the already long-standing systemic health and social inequities that exist in these communities.

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HCB News: I know you're a big advocate for teleradiology. How is it helping rural patients now, and how might it be able to do more?
EF: Teleradiology has proven to be a great benefit not only to our rural communities, but also to metropolitan, suburban, academic, and VA/military practice environments. Teleradiology provides both internal and external medical support, which can be efficiently and economically leveraged to provide high-quality imaging interpretation and improved, comprehensive care around the clock. The hardships that some rural practices have recruiting and retaining radiologists during times in which demand for radiologists is historically strong, also factors in to why teleradiology can be beneficial. Teleradiology complements on-site radiologists' skills, and, in turn, enhances patient care, by providing access to specialized expertise without increasing the time or cost to obtain such expertise. When uncommonly challenging cases arise, teleradiology offers a way for smaller groups to obtain a second opinion from off-site group members who may have a greater focus or fellowship training related to the case at hand, or to obtain the same type of consultation from a contracted teleradiology service. The ability to aggregate imaging studies onto shared radiologist work lists also allows radiologists who are at smaller, lower patient volume facilities to stay busy by supporting other busier facilities in the practice. These economies and efficiencies are emerging as critically necessary capabilities to offset falling reimbursements, increasing costs, and the ever-dynamic regulatory and legislative requirements that all face, but at times disproportionately impact rural practices.

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