January 2020 saw the beginning of an unprecedented event that impacted countries from around the world. The onset of the COVID-19 pandemic changed the way we work, the way we play and the way we educate. Never before actions have taken place on such a wide scale that it is difficult to predict what the world will look like once this crisis has passed. One thing is for certain. Our lives have changed.
Nowhere is the impact greater than on our healthcare system. This pandemic has raised questions about our capabilities and preparedness for such events. It has made us realize we are woefully unprepared and has forced the healthcare industry to re-evaluate how we deliver healthcare in the future. A social media image is asking the very valid question “Who led the digital transformation of your company: CEO, CTO or COVID?”
Nowhere is this more apparent than in the discussions around tele-health and tele-radiology. Many facilities have rushed to acquire equipment in order to enable physicians to work from home and many facilities that previously were hesitant to allow remote work are reconsidering. But what concerns should a facility consider in order to ensure physicians are most efficient when working remotely?
There is nothing more frustrating than trying to view a large dataset and having the time to grab a coffee while the data is downloaded to the desktop. The impact on efficiency is so great that it might be faster to drive to the office to work, thus defeating the purpose of remote work. A system must be able to download images and allow for review of those images at the same time as they arrive thus speeding up the review cycle. There are various methods to accomplish this and any tele-radiology system should enable fast review.
With the advent of more people working from home, cyberattacks will increase as hackers look to take advantage of weaker home environments. Any home system should consider using a VPN system to secure transmissions as well as encryption of medical information. The American Medical Association and American Hospital Association have provided a comprehensive guide to working from home that applies a post COVID-19 world as well as during the current crisis.
Many remote applications provide limited functionality as CPU intensive post processing functions are not deployed or accessible. With server side rendering technologies some applications are able to function remotely without the receiving computer needing massive resources. Some modalities, in particular, Nuclear Medicine, leverage third party applications that don’t support remote access or require “dial in” capabilities. These processes impact performance and increase security risks. Additionally, remote access has been used for initial reports but requires being in the office to finalize reports. In order to promote the most efficient workflows, remote access systems should enable final reports to be issued and sharing of those reports to the relevant physicians and IT systems.
Along with functionality comes integration to the IT systems that provide much of the information required to do adequate reporting. Upfront information connecting to patient information such as the practice management system of Electronic Medical Record provides crucial information to the physician. This can be difficult to access remotely. Similarly, when a report is generated that report should be integrated back into the EMR or RIS for access by the referring physicians.
Remote work can be extremely productive and improve access to physicians but there are many challenges to be considered before a broad segment of the physician population can begin working from home. COVID-19 has raised awareness to the current shortcomings and has caused us to implement a crisis response but for the longer term we must find ways to overcome these challenges.