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TMC has now reported more than 50,000 digital cases since the launch of its new telepathology service and its new “OPTEMIS for Pathology” platform is almost ready for production, allowing TMC to plan for a significant scale up within this area with more pathologists, more Swedish clients to build on our initial client projects in the UK.

TMC is no stranger to finding innovative ways to tackle perennial problems and as early as 2004 we started our first pilot into digital pathology. Unfortunately, we were ahead of our time and the technology was not yet in place to do this effectively.

But in recent years, technology has improved to the point that TMC is now ready to take on large scale telepathology. This technology now includes the use of new high-speed scanners, which can scan (with high precision) the glass slides that you normally put under a microscope to look for pathological findings in tissue. These scanners became available in around 2010 and it was this development that prompted TMC to revisit this area based on its improved ability to facilitate far better digital pathology results and telepathology than the previous systems.

According to Henrik Agrell: “We decided to enter the telepathology market because it has so many similarities with the teleradiology market. At its most basic, it boils down to sending digital images to highly qualified doctors – and these doctors can be located almost anywhere. Across Europe, there’s the same shortage of pathologists as there is of radiologists and we think this is a great opportunity. We’d like to replicate our success in teleradiology and apply those same techniques to telepathology. Ultimately, we think this can help to take further pressure off the system and our aim is to use this technology to offer as many patients as possible access to sub-specialised pathologists. As far as we’re aware, we are the only group currently providing a telepathology reporting service, which we first launched in 2013 with our remote reporting for Linköping University Hospital in Sweden.

According to Dr. Michael Dictor, TMC Head of TMC Pathology section: “Each hospital must be able to scan their glass slides to generate a digital image of the tissue specimen. Currently, the TMC pathologist enters the hospital’s LIS (Laboratory Information System) and uses the image viewer solution to do the reporting. While this approach is adequate, it’s a bit slow and limits the possibilities to work with more hospitals. TMC’s subspecialist model, aims to ensure most cases are reported by a subspecialist within a relatively narrow diagnostic area and to do this, our pathologists need access to specific case types from many different hospitals. However, to log into a large number of different systems is complex and time consuming. Now, with our new OPTEMIS for Pathology platform, they can access all these reports on one system. OPTEMIS for Pathology also offers other advantages such as advanced quality control, professional support for prospective peer review, structured reporting and more.”

Henrik continued: “Right now, we’re working with 3 hospitals in Sweden: Linköping, Jönköping and Växjö. However, within a year, we aim to have 3-4 times more pathology clients up and running, which means we’ll need at least 10-15 additional pathologists during the coming 12 months. That process is already well under way with several new pathologists having already successfully completed the TMC pathology test cases and others about to start.

“TMC is planning to replicate many of the practices we successfully use in our teleradiology business to support as many pathology departments as possible with access to subspecialist pathologists via state-of-the art telepathology solutions. We want to make sure patients can get the best possible care based on accurate diagnostic decisions without long waiting times. Our excellent software development team has of course played a very important role in this project. Again, we see the unique advantage of having an internal software development capability within TMC”.

Telemedicine Clinic started an awareness campaign earlier this year – and the results are already starting to pay off. As one of the leading teleradiology providers in the UK, we are in a strong position, with great capacity to support MSK work across the NHS and we know that this capacity can make a real difference as Trusts struggle to manage their increasing workload and cope with the very real capacity gap that exists in the NHS today.

The awareness drive started in May this year and we took the message across the UK to make sure that the profession are fully aware of the options that we can provide and how we can help to relieve some of the pressure that we know they feel every day.

The national campaign included display ads (in respected industry publications such as RadMag) combined with local sales activities, promotional flyers and generally reaching out to our key contacts to remind them of how we can help.

Our main priority was to introduce potential clients to the advantages of our elective services and so far, the results have been encouraging.

According to Chris Piccaver, TMC’s UK sales manager: “We’ve tried similar approaches in the past and we’re pleased with the results so far. We’ve generated a lot of interest through this campaign and it has resulted in a number of face to face meetings, which we hope will pay off over the coming months. Once clients get to meet us face to face and they get a sense of how committed we are to providing the best possible service, they really start to understand the benefits of what we do.”

“While we’ve already been able to support a number of new clients with their elective requirements, we still have even more capacity available (especially in the area of MSK), so any Trusts out there who would like to find out more about how we can add real value to your local proposition, we’d love to talk to you”.

“The campaign will continue throughout the summer and we’re confident that as the word spreads, our early success will continue to provide more opportunities over the coming months.”

For more information, contact Chris Piccaver: cpiccaver@telemedicineclinic.com

The year was 2007. Apple had just introduced a new piece of technology called the iPhone and nobody was sure it would ever take off. The new Wembley stadium was completed in London: Beyonce was asking all the single ladies to “put a ring on it”; and Nicolas Sarkozy was elected President of the French Republic.  

It was against this backdrop that Henrik Agrell and Hans Billing were discussing a novel idea that would potentially change the radiology scene for the better – reporting night time emergency radiology cases from an opposite time zone. At first, the idea seemed a bit far-fetched, but the more they talked it through, the more sense it made.

Not only would it take pressure off the system in Europe, but it would also allow better planning of daytime resources for the client radiology department management with radiologists only working normal day shifts. They would get a better work-life balance with more time to spend with family and friends. They could say goodbye to long, arduous night shifts and deliver better quality reporting for their clients back home.

Henrik and TMC’s then CEO David Bäckström decided to travel to Australia to investigate financial, legislative and logistical issues and managed to rent a small shared office space in the Lane Cove Business District in Sydney’s northern suburbs.

Henrik contacted Dr Hampus Eklöf, a radiologist from Uppsala who had just written an article about daytime reporting of night time radiology cases and a radiologist and a technician from Uppsala University Hospital were soon sent from Europe to report on their cases from a Sydney apartment. While the management in Uppsala did not hook on to the idea, Dr Eklöf did and Henrik persuaded him to get on board as TMC project manager to help to roll out the idea.

After almost a year of planning, recruiting and trying to find clients interested in trying this idea, he and Agneta Blomquist, a radiographer from Uppsala set up a month’s trial testing it out from the TMC office in Barcelona, before taking it the whole way to Sydney.

In August 2007, Hampus, Agneta, Dr Kjell Westerberg, Dr Cecilia Salmonsson and Operations Manager Virginia Westerberg boarded a long flight to Sydney and after a few weeks of frantic work setting up the office, they were ready to successfully receive the first night´s emergency cases from Kristianstad county hospital on August 13th.

According to Henrik, TMC’s Chief Business Development Officer: “During the start-up phase we only had one client hospital and alongside the original team, we had an Australian office manager and an IT technician. It was a costly first year and (as with all new projects) it was not without its early hiccups, particularly around IT related and logistical issues. But today, we are able to provide a very reliable solution to many hospitals in Scandinavia and the UK. These hospitals really benefit from having access to senior radiologists that read their night time cases during normal business hours while their own radiologist can sleep and be more accessible during day time. ”

The next year, in October 2008, TMC got its second client hospital (Östersund) and Hans Billing was sent to Sydney to review the operation first hand and to assess its longer-term potential.

Hans continued: “When Hampus left Sydney to return to Sweden, I took over as MD and Head of On Call. By the third year, we had got another 3 hospitals and our service had become better established and well known in the Swedish radiology community. It soon became clear that the office was not functionally effective and we were a long way out of town in the Sydney suburbs, so in 2009 we moved to the Sydney Central Business District where we already had some contacts with the world´s largest teleradiology company, Nighthawk. They let us take over some free space in their huge office only a few hundred meters from the famous Opera House.

“After a year, Nighthawk was sold to the world´s second largest teleradiology provider and, after bouncing around a few more locations in Sydney, we moved to our own purpose-chosen, refurbished office on Bligh Street. Ten years later, we still have our office there and growth has meant that we also have several radiologists working from other remote places of their choice, such as Queensland, Australia, New Zealand, Canada and all over Europe (the latter for coverage during the European evening hours)”.

By 2010 TMC had its first English on-call client and by the following year, we had our first Danish hospital. Today, TMC serves over 30 UK clients, almost 50 Swedish and 5 Danish hospitals. There are 21 radiologists working at the office and another half dozen working from their home work stations across Europe, North America and Australia/New Zealand. Many radiologists also help to provide part time cover from Europe for the early hours for UK On Call and 7 operational staff and one IT technician work full time at the office, all supported by our great team back at the Barcelona and Reading (UK) offices”.

Hans returned to Europe in early 2016 and Dr Fausto Labruto took over as managing director and head of TMC’s Emergency Radiology Section.

Looking back on those early days, Hans commented: “I’m really proud of the enormous efforts made by so many loyal colleagues in Sydney over those 10 years. I’m also really pleased that our initial idea of night time emergency reporting from a different time zone proved so visionary and is still the model that we use today.”

Fausto Labruto added: “It’s been quite a journey. Since those early days, more than 100 radiologists, over 30 operational staff, and 4 IT technicians have contributed to our success and last year, we invested in our Sydney office to provide more space and better facilities for the record number of colleagues now working there, who now total 21 radiologists and 7 radiographers. And we’re continuing to expand, with plans in place to set up a subsidiary office in Noosa, Queensland.

“So, we have a landmark to celebrate – 10 years of ground-breaking work and business success, built on a great vision, hard work and the determination of our talented and committed colleagues. A huge thanks to all those who have contributed to our great success. We plan to celebrate with a glass of champagne at the office and then we’re all going to have a great party in September. I am so proud of this team of amazing colleagues. It’s been a real privilege to have been a part of this visionary and successful project and we can’t wait to start to continue to build a strong future right here in Sydney. Here’s to the next 20 years!”

In a recent trial for the Västra Götaland region in Sweden, TMC worked closely with the local radiology teams at 5 hospitals and demonstrated that networked solutions can have a dramatic effect on releasing radiology capacity, enhancing quality and improving medical outcomes. The results speak for themselves – a whopping 27% increase in efficiency over the period of the trial…

According to Henrik Agrell, Founder of TMC: “We’re delighted at the success of this trial. TMC had been working with VGR as a client for several years, so we already knew them well. We also knew the challenge they were facing and we knew that our CDxN tool could help them to solve their problem. The results speak for themselves – a 27% increase in efficiency, quicker access to subspecialty knowledge, better patient outcomes and a reduction in discrepancy rates. We’re pleased with the way the partnership approach worked with VGR and we’re already in discussions to expand our network to help them with other high-volume areas such as MSK.

According to Dr. Katarina Wahlstrom one of the participating radiologists from VGR: “This was a great project for us and I would recommend it to other hospital groups. It was as if I immediately had extra colleagues (with more specific MR body experience than I had) to reach out to and to discuss cases directly with. Being able to ask them questions about real exams made my reporting more confident. Also, being at my own hospital, it was comforting to know that regardless of who was on duty, I could always reach out to a TMC expert for a discussion about the case specifics”.

 The key findings from the project are:

• 5 VGR hospitals were connected via TMC’s proprietary platform OPTEMIS-RIS and all workstations for network reporting were provided sub by TMC
• The project focused on body cases which were given individual review by TMC Body MR subspecialists
• The VGR MR body team was established and enabled radiologists who had not known each other to communicate and support each other frequently
• All cases first read by VGR specialists were assigned to TMC MR body subspecialists for a second reading
• Changes were then highlighted on the system by the second reader, marked up and returned to the first reader for review
• This allows a fast track to subspecialty knowledge and develops substantial subspecialty expertise within the group
• VGR radiologists also received interactive, online case-based training to build up further MR body reporting skills
• Using TMC’s RAD-Unit measurement approach, reporting efficiency improved by 27% and reporting efficiency improvements were clearly established after reviewing approximately 300 cases

Stay tuned: we will be publishing a full, downloadable copy of the report on our blog in the coming weeks.