The Philadelphia area has five accredited Level I adult trauma centers. To receive the designation of a Level I trauma center, the hospital must be able to provide the highest level of definitive, comprehensive care for the severely injured adult patient. Under the 2011 standards for trauma center accreditation, a Level I facility must have an attending radiologist capable of diagnostic, invasive and therapeutic procedures promptly “available” 24 hours a day. The accreditation requirement does not require an attending radiologist be present in-house and leaves it to the discretion of the hospital if the attending radiologist must respond in-house.
Thus, even a Level 1 trauma center isn’t required to have an attending radiologist in-house 24/7. Many area hospitals utilize teleradiology services during the night to read and interpret diagnostic studies. As a result of improvements in technology, imaging can be easily transmitted to remote locations, thus saving physicians the time of having to travel back to the hospital to interpret a study or film that could be done on the computer at their homes. In its nascent stage, the idea of having a radiology resident reviewing a film in-house and the attending physician confirming a diagnosis remotely has advantages for the patient, the physician and the institution. When important care decisions depend upon the interpretation of a diagnostic study in the middle of the night, it would seem better not have to rely on the “wet” reading of the surgeon backed up only by a radiology resident. An attending radiologist can then participate, but doesn’t have to be in-house overnight. Smaller hospitals (and non-teaching hospitals) also benefit from teleradiology and theoretically can improve patient care in a cost-effective manner. When teleradiology studies are provided by a Pennsylvania-licensed radiologist and the practitioner is affiliated directly with the institution where the patient is receiving care, it can be a cost-effective way to improve patient care.
