Case Volume, Response Times

1
Case Volume, Response Times User Satisfaction
With a University-Based Teleradiology Program

• Elizabeth Krupinski, PhD, Kevin McNeill, PhD,
  Theron Ovitt, MD, Michael Holcomb, Kreg Lulloff
• Presented at
• The American Telemedicine Association Conference
• April 18-21, 1999
• Salt Lake City, UT

2
Goal

• The goal of this project was to evaluate the
  teleradiology component of the Arizona
  Telemedicine Program in terms of patterns of
  usage, turn-around times, and user satisfaction.

3
Rationale I

• The University of Arizona Department of radiology
  has operated an active teleradiology program for
  over 2 years as an integrated component of the
  Arizona Telemedicine Program

4
Rationale II

• Evaluation of various program components will
  help us with
• Determine the success of the program
• Make changes necessary to improve the program
• Schedule radiologists to cover cases
• Update the teleradiology hardware/software
  components

5
Teleradiology Sites

• There are 4 sites in Arizona supported with
  dedicated teleradiology systems
• 2 are located within Tucson
• Tucson VA Hospital
• Kino Community Hospital
• 2 are located in East Central Arizona
• White River
• Springerville

6
The Network

• 3 of the sites are connected to the University
  Medical Center via the high-speed (T1) Arizona
  Rural Telemedicine Network (ARTN)
• 1 site (Tucson VA) uses dial-up service

7
Viewing System

• The receive station in the Department of
  Radiology at the University Medical Center is an
  IVIEW PRO 2.1 from Lumisys Corp. (Sunnyvale, CA)
• Images are viewed on a 1024 x 768 color monitor

8
Services Provided

• Specialty consultations
• Over reading of cases
• Backup coverage when rural radiologists are out
  due to illness or vacation

9
Who Reads the Cases

• Cases are read by radiology residents when the
  cases first come in
• The residents provide a wet read for the rural
  sites (fax or call)
• Cases are over read by the board-certified
  radiologists fellows
• Radiologists provide the final report

10
Case Records

• Cases are logged in with the following
  information
• Patient name
• Referring site name
• Modality (e.g., CT-Head)
• Number of images
• Date
• Time

11
Analyses

• The following 3 aspects of the program were
  evaluated
• Case demographics
• Radiologist satisfaction
• Case turn-around times

12
Cases

• Over 1500 teleradiology cases have been reviewed
  since May 1997
• On average, 95 cases reviewed each month
• Percent cases from each site
• 45 cases from Tucson VA
• 25 White River
• 19 Kino
• 11 Springerville

13
Case Volume
14
Case Modalities
15
Images

• 44 of all cases are CT- head followed by 14
  CT-abdomen
• Number of images per case
• Mean 25.58
• SD 24.10
• Minimum 1
• Maximum 242

16
User Satisfaction

• A survey was developed to assess who is reading
  the teleradiology cases and how satisfied they
  are with the teleradiology system
• 17 faculty, 1 fellow and 6 residents responded to
  the survey

17
The Survey

• 1) Have you read any cases using the UofA
  teleradiology system?