3 December 2007
Just transmit X-rays for fast results -- SingHealth outsources some of its work via teleradiology to S'pore-registered semi-retired but competent radiologists
The Straits Times - pg H3

By Lee Hui Chieh
 
IT IS called teleradiology, and it has sped up X-ray reading, which can now be done within an hour, instead of a day or two.

Public health group Singapore Health Services (SingHealth) has been outsourcing some basic X-ray work through teleradiology, or transmitting images from one location to another, where they are read.

Five of its nine polyclinics - Bukit Merah, Geylang, Pasir Ris, Sengkang and Tampines - offer X-ray services.

In a one-year pilot project that began in June this year, the polyclinics are sending about 50 of their daily load of 250 X-rays to a company called Medisol, which hires semi-retired radiologists to read the images.

The three radiologists - who are Singapore-registered specialists - from Medisol's office in Bukit Batok go through the images, then transmit their findings back.

Another 50 or so X-rays are sent to the SingHealth-run Singapore General Hospital (SGH). The rest are sent to Tampines Polyclinic, where they are read by an SGH radiologist stationed there.

Previously, without teleradiology, X-ray films were couriered in batches from the other polyclinics to Tampines, and returned with reports only after a few days.

So, polyclinic doctors meanwhile read the X-rays first and treated patients accordingly before the reports came back, said Dr Soo Wern Fern, a senior family physician at Pasir Ris Polyclinic.

But sometimes, they missed hard-to-spot abnormalities that the radiologists would later pick up.

She said: 'Teleradiology gives us more confidence as our findings are supported by the radiologist on the spot.'

Four years ago, patient Quek Huan Hua, 60, was told over the phone that his results were normal two days after his X-ray. He feared kidney problems as the side of his torso had been aching.

This month, after seeing the doctor for a severe nosebleed, he got his results - again normal - after one hour.

He said: 'This saves me from worrying for two days.'

SingHealth's teleradiology project began in February last year, with Sengkang Polyclinic transmitting its X-rays to the one in Tampines. It was then extended to other polyclinics and hospitals.

Every day, SGH now farms out 50 to 70 X-rays of its own patients to Medisol, and another 100 to KK Women's and Children's Hospital.

The plan is for hospitals to help any sister hospital that is strapped or needs specialised expertise, said Dr Tan Bien Soo, 47, head of SGH's department of diagnostic radiology, who chairs SingHealth's teleradiology workgroup.

In future, the group hopes to outsource more routine and basic work to companies like Medisol, and take on more complex and specialised work, say, paediatric or neurological radiology, from other institutions.

The other public health group, the National Healthcare Group, has been outsourcing the X-rays of its nine polyclinics, through teleradiology, to a reading centre in India since December 2005.

Outsourcing to Singapore-registered specialists skirts a potential minefield -- holding a foreign-registered doctor responsible if he gives a wrong report through teleradiology, Dr Tan said.

Medisol's three radiologists had closed down their own 35-year-old practice last year to work part-time.

One of them, Dr Kho Kwang Mui, 72, said all three of them still have to go for continuing medical education to continue practising, like other doctors. He added: 'Reading X-rays is well within our competence.'