Teleradiology: Evaluating Medical Images From Around the Globe

First used by the Army in early 1991 during the Persian Gulf War, teleradiology subsequently "deployed" to Somalia, Haiti, Bosnia, Kosovo, Hungary, U.S. Navy ships, and, most recently, to Afghanistan and Kuwait.

Radiology is the science dealing with X-rays and other types of radiant energy used in medicine for X-raying bones, organs and for diagnosing and treating disease.

"The technology today is so advanced that a clinic sending exams electronically thousands of miles away provides the same image quality as the images coming from their own in- house radiology department," said Tom Lewis, who addresses teleradiology issues for the Air Force Medical Logistics Office.

In March 2002, for example, images for a soldier in Bosnia diagnosed with a brain tumor were reviewed first by neurosurgeons at Landstuhl Region Medical Center in Germany. Later that day neurosurgeons at Walter Reed Army Medical Center in Washington saw the same images and consulted with Landstuhl medical officials on the best methods to treat the patient, who was medically evacuated to Walter Reed.

In large part, the exodus of uniformed radiologists from the military has fueled the need for military teleradiology systems.

In fact, between 2002 and 2005 "the Army is projected to lose 33 (of its 113 radiologists), with no guarantee of replacements in sight," said Bob De Treville, the program manager for Army teleradiology initiatives at Fort Detrick, Md.

"Radiologists are in high demand everywhere," said Chris Riha, a clinical engineering consultant for the Army's teleradiology program at Detrick. "Their counterparts in civilian sectors are among the highest income group of practicing physicians."

For example, recent postings on Radiology Jobs Online feature positions that offer radiologists $200,000 to $400,000 as annual base pay.

To retain radiologists, the Air Force, Army and Navy are focusing on making radiologists' jobs and lives easier - and teleradiology is playing a big part.

Radiologists, noted De Treville, work "incredible" schedules and are often on call because "someone's got to read the images, and quickly."

Teleradiology allows radiologists to be virtually anywhere reading images whether the images come from a nearby base or across the ocean from a tent via secure, high-speed connections.

The Army, Air Force and Navy all have teleradiology experts who work at Fort Detrick. Although the services may use different equipment, all conform to the same industry standard.

"The interaction with my counterparts in the other services continues to prove invaluable," said Dima Smirnoff, an engineer with the Navy Medical Logistics Command at Detrick. Smirnoff works on the image archiving and communications aspects of teleradiology.

"Being located close to each other here at Fort Detrick gives us the opportunity to coordinate our efforts in digital radiology," Smirnoff continued, noting this also allows "better ability to field systems that are more compatible between services than otherwise would have been possible."

Using teleradiology, the Air Force now "can send (radiological) exams to any number of Army or Navy military treatment facilities for assistance, if necessary," Lewis pointed out.

"I expect that over time these relationships and connections will continue to evolve to where we will have a 'virtual radiology department' that connects all Air Force, Army and Navy facilities together as one," he concluded.

(Karen Fleming-Michael is a writer and public affairs specialist at the Fort Detrick, Md., Public Affairs Office.)