Archive | Case Studies
Karlstad Hospital meets the regional target for mammography screening services
Karlstad Hospital faced a severe lack of reporting capacity for mammography screening due to the fact that they had insufficient mammographists onsite. The hospital was pressured to meet the local health authority target for compulsory mammography screening, which was to extend these services to a broader age group of women. The volume of cases began to increase significantly and rather quickly. Trying to keep up, mammographists became fatigued and stressed.
TMC and Karlstad Hospital teamed up to develop a solution whereby the TMC mammography team performed the second reading to fulfill the double-reading requirements of the hospital. TMC was able to provide additional capacity through second reading by another qualified radiologist to confirm the reading and ensure accuracy.
Karlstad Hospital met their target and continues to provide mammography screening to a larger base of women patients.
“I am very satisfied with the collaboration with Telemedicine Clinic and would like to especially point out the good collaboration we’ve had with TMC’s mammography doctors.”
Birgitta Andersson, Head of Mammography, Karlstad Hospital
Esbjerg Hospital improves work conditions for their radiologists
Esbjerg Hospital in southwest Denmark faced difficulties in recruiting radiologists with specialist competencies, a seemingly common problem for hospitals located in remote towns and cities. A shortage of competent radiologists meant that existing staff had to scan complex cases during the day and then read them during nights and weekends. The radiologists worked long-hour shifts and were inevitably fatigued. The potential risk in delivering inaccurate readings was rising, which worried staff members tremendously.
TMC stepped in to support Esbjerg Hospital in bulk and routine reporting for complex and non-complex CT and MRI scanning. Backlogs were cleared and work conditions improved for the radiologists. TMC continues to work collaboratively with Esbjerg Hospital to provide additional capacity as well as to build up specialist competency internally and improve capacity for future demands in specialist reporting services.
Uppsala University Hospital receives emergency assistance in reporting for Neuro cases
Uppsala University Hospital in Uppsala, one of the leading teaching hospitals in Scandinavia, ran into a major problem when some of their leading Neuro radiologists left to take on other job offers. With a sudden shortage of Neuro radiologists, the hospital experienced a backlog of cases and diagnostic waiting times increased substantially. The fact that patients were not being treated in a timely manner provoked anxiety in the patients and medical staff. This proved especially risky for patients with severe Neuro conditions like brain tumours.
Responding to the hospital’s urgent need, TMC set up and implemented an efficient workflow process in 2 weeks so that TMC’s sub-specialist radiologists could read and report Neuro cases for the hospital in fast turnaround time.
Lund University Hospital reduces waiting times for complex oncology cases
Lund University Hospital in the south of Sweden was faced with unacceptably long diagnostic waiting times for their complex thorax and abdominal oncology cases, due to the lack of specialist competency in these areas. This was a grave problem particularly for at-risk cancer patients who needed timely diagnosis in order to receive follow-up treatment. The long wait for patient diagnosis not only produced anxiety in the patients themselves but also in the medical staff that felt the pressure to treat their patients as quickly as possible.
TMC stepped in to provide Lund University Hospital with the specific competency they needed. With a team of thorax and abdominal sub-specialists at hand, TMC was able to deliver reports for non-complex and complex oncology cases in a timely manner. Reports for outpatient cases were turned around in less than 48 hours.
Lund University Hospital managed to shorten their waiting times substantially through their partnership with TMC. Patients were treated at a faster rate, reducing anxiety experienced by patients and medical staff.
“TMC has been a good complement to us when we lack radiologists.”
Dr Peter Hochbergs, Head of Radiology, Lund University Hospital
Santa Tecla Hospital Network builds and strengthens their MRI facilities
The Santa Tecla Hospital Network in Tarragona launched an MRI scanner diagnosis service for their three hospitals. However, the team of onsite radiographers did not have experience in MRI scanning.
TMC presented the hospital network with a complete and long-term solution that included training for radiographers; establishing MRI protocols; overseeing project implementation; providing on-site remote support to operations; and diagnostic imaging reporting. TMC continues to partner with the Santa Tecla Hospital Network in ongoing planning for effective MRI delivery, medical demonstrations and improved communications between TMC radiologists and referring clinicians.
The Santa Tecla Hospital now has the appropriate resources and expertise to offer their patients efficient in-house MRI services.
Karolinska University Hospital reduces waiting times for CT and MRI thorax cases
Karolinska University Hospital in Stockholm had experienced an under-capacity in reporting for CT and MRI thorax cases. The hospital was faced with an increasing backlog of cases and subsequently increasing waiting times for results.
TMC and Karolinska University Hospital initiated cooperation to meet the immediate need in reducing waiting times. Cases were sent to the TMC Sectra PACS via a secure connection through the Swedish national healthcare network, Sjunet. These cases were reported by TMC radiologists specialised in Body Imaging.
Karolinska University Hospital’s reporting needs was changing from week to week. Respecting the hospital’s variable needs, TMC continues to offer a very flexible solution that gives the hospital the possibility to order reporting services at short notice.
“I am very satisfied both with the quality of the reports as well as the administrative contacts with TMC. TMC has fulfilled all agreements made to my full satisfaction. I also find that contacts with both management and clinical personnel are easy to make and that our opinions are treated well and with a positive attitude.”
Bo Persson, M.D., Ph.D., Chairman and Head of Radiology Department, Karolinska University Hospital, Huddinge
Kristianstad Hospital increases reporting capacity and improves working conditions for their radiologists at the same time
Kristianstad hospital in southeast Sweden was faced with a lack of capacity for daytime cases while their radiologists spent a lot of their time reporting on out-of-hours or on-call cases. The hospital performed 85,000 exams a year with a large number of trauma cases. Adhering to the EU working-time directive, the radiologists who worked on-call were not allowed to work the following day after performing their on-call duty. This inevitably meant that Kristianstad hospital were short on staff to handle daytime cases. The backlog started to grow tremendously and waiting times increased.
Training and support was another issue. Since on-call production required a substantial number of radiologists at a time, residents found it hard to coordinate and work with senior consultants for training purposes. Opportunities for training and support were scare.
TMC stepped in to support Kristianstad hospital on on-call reporting. With a center based in Sydney and leveraging the time difference between Australia and Europe, TMC’s awake and alert radiologists were able to perform nighttime reporting (from 22:00 to 07:00) for the hospital four days per week. The reports were written in Swedish into the hospital’s RIS system. Relieving radiologists from on-call shifts meant that they could then work on daytime cases. In addition, with a full staff during daytime hours, residents were able to receive training and support from their senior consultant colleagues.
“We’ve managed to overcome several problems at once through our cooperation with TMC. With their on-call support during nighttime hours four days a week, we are now able to have more radiologists available for daytime shifts. This means a lot to us as our radiologists now work during more humane hours while they are awake and alert. Just as important is the fact that our residents can now receive proper training from their senior peers.”
Tore Rojlar, Head of Radiology, Kristianstad Hospital
Barnsley Hospital meets Diagnostic Targets and gains Foundation Status
Barnsley Hospital NHS Trust, a district general hospital in South Yorkshire, provides acute services to a population of 225,000. In 2005, the hospital faced surmounting pressure to reduce waiting times and to meet diagnostic targets. This proved to be quite challenging as the hospital experienced a shortage of consultant radiologists to read the rising volume of images. The hospital was therefore left with a backlog of unread images and patient waiting times continued to increase. In addition, Barnsley Hospital’s exisiting radiologists were overworked and stressed, which was cause for concern in terms of working conditions as well as diagnostic accuracy.
As part of its drive to meet national diagnostic targets and to achieve foundation status, Barnsley Hospital commissioned TMC to read bulk examinations amounting to a minimum of 12,000 X-rays and 1300 MRI scans per year. The images were sent via a secure network to TMC’s team of qualified radiologists who returned diagnosis in a timely manner.
TMC exercised a partnership approach, working closely with Barnsley Hospital’s medical imaging department to help identify underlying issues that led to long waiting lists. Together, we developed appropriate solutions for increased productivity, exploiting the hospital’s existing cutting-edge technology. A continuing working partnership has resulted in Barnsley Hospital achieving foundation status; and receiving a rating of “excellent” for early diagnosis and superior patient care from the Healthcare Commission.
“We were very grateful for all the support we received from TMC whilst our department was being reorganised and re-developed. This was potentially a very difficult time for us, however, by working in partnership with TMC, we were able to offer a high quality radiology service within the target set by the NHS.”
Stewart Yates, Clinical Director, Barnsley Hospital
TMC supports over 60 NHS hospitals with MRI reporting
Many NHS hospitals in the UK were faced with long waiting lists, one of the longest in Europe. Patient treatment was delayed particularly due to a shortage of MRI reporting capacity, resulting in increased anxiety among both patients and doctors. The UK Department of Health had set targets to reduce the patient waiting time from referral to treatment, which meant that diagnostic waiting times had to be reduced.
TMC began to work on a contract with Alliance Medical to support NHS hospitals with MRI reporting. Alliance Medical performs MRI scanning in mobile units and the images are sent to TMC radiologists to be read with a 24-hour turnaround time. Alliance Medical and TMC performs 4000 examinations monthly, supporting more than 60 hospitals in the UK.
“The provision of MRI scans to the NHS within the first wave diagnostics contract has undoubtedly contributed in a major way to the reduction of patient waiting times. TMC is pleased to have played a large part in providing the radiology reporting service within this contract. Undoubtedly, there were problems in the early stages of the contract but TMC has strived to provide a high quality service, reporting approximately 4000 MRI examinations a month to more than 60 NHS hospitals.
In such an environment, it can be difficult to please “all of the people, all of the time” and there can be a feeling that the radiologist is remote. But we are increasingly in regular contact on the phone or by means of follow-up letters with many of the clinicians who receive our reports, just as it happens in a conventional radiology setting. We are now moving into a new era in the UK and, where a teleradiology reporting service is able to support a hospital radiology department, a more direct relationship with the hospital is preferable so that the relationship between referring clinicians, local radiologists and teleradiologists can be strengthened to facilitate clinical communication and improve client satisfaction.”
Nicola Bees, Consultant Radiologist, TMC
Trollhättan Hospital increases job satisfaction by offering professional development opportunities to their radiologists
Trollhättan Hospital in western Sweden was experiencing problems in retaining competent staff. A senior radiologist had left and the hospital had hired a locum radiologist for almost a year. Regional authorities did not allow the hiring of more locums. In addition, the hospital was close to losing their only MRI radiologists to the university hospital in Gothenburg. The two relatively junior radiologists were looking to develop their skills more efficiently and this did not seem possible at Trollhättan hospital. If they were to leave, the hospital would lose all MRI reporting capacity and would therefore have to refer such cases to other hospitals. A hospital with a rather limited reporting capacity provides little growth incentive for existing radiologists and would not attract future recruits.
Trollhättan hospital saw the urgent need to provide incentive to their radiologists and to retain specialist competency in-house. They partnered with TMC to implement a training solution whereby their junior radiologists performed the first reading after which TMC sub-specialists would perform the second reading or over-reading, which works as an efficient training method. In addition, when patient volumes were high, TMC stepped in to provide additional reporting capacity for complex and routine bulk examinations.
Radiologists at Trollhättan hospital were satisfied with the training program and were finally seeing opportunities for their own professional growth. The two junior MRI radiologists eventually stayed to help build the hospital’s MRI reporting capacity.
