Maritime Teleradiology is still in its infancy but land based teleradiology has been utilised in a number of remote areas and there is good data in support of its efficacy.

Successful and clinically relevant teleradiology requires robust technology coupled with expert specialist opinion. It also places significant demands on ship's medical staff to produce images of diagnostic quality. There is a corresponding need for crew training and continuous quality management to ensure that the benefits of an innovative service are maintained and maximised.

An integrated approach is essential to develop and sustain a high quality clinical service. Teleradiology must comprise more than the text of a radiological report, online advice and support are vital. Every examination should be considered to be a training opportunity to allow ship's medical staff to increase their skills. Radiographic standards are also improved by feedback and advice on every exposure.

Teleradiological opinions are valued enormously by ship's doctors and this diagnostic support facilitates high quality medical care. The collegial support and training also enhance recruitment and retention of staff.

There is an increasing awareness of health issues among the travelling public and this is particularly true of the cruise ship passenger. There is also the widely held view that the medical facilities on a ship are equivalent in every respect to a shore-based hospital. This perception is set against the background of a very low threshold for litigation.

Teleradiology assists cruise lines to minimise the risk of litigation in the event of medical complications and it allows the confident repudiation of frivolous claims.

Consultant Radiologists

Dr Stephen Birch Bsc MRCS LRCP MB BS DMRD FRCR
Dr Vincent Batty BSc MB BS DMRD FRCR MSc
 

References

1. Teleradiology - An Integrated Solution

V Batty
International Marititim. Health (2002), 53, 1-4

2. Teleradiology improves quality of care in Finland

T Paakkala, M Kiuru, T Kallio
Diagnostic Imaging Europe (2001), 17(7), 27-31

Primary healthcare in Finland shares some of the characteristics of cruise ship medical centres. This paper examined the benefits of Teleradiology to a small primary healthcare centre serving 8050 people.

Of 446 examinations selected for transmission by the referrer:

Pathological findings were found in 53%
15% of these had not been diagnosed by the general physician
The physicians made 80 false positive diagnoses and their overall specificity was 62%

When all examinations were transmitted specificity improved to 86%

Teleradiology affected management significantly in 19%
Unnecessary treatment was avoided in 5%
Unnecessary transportation was avoided in a further 5%

Teleradiological consultation saved 5% of examined patients from being hospitalised.

They conclude that the general opinion among physicians and patients in primary health care centres is that Teleradiology increases patient safety. It is relatively inexpensive and offers a way to provide quality healthcare if 0ne-to-one consultation is not available.