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Teleradiology speeds doctors' diagnosis time By BILL KETTLER Mail Tribune Dr. Mack Bandler still climbs out of bed at all hours of the night, but he doesn't run out the door like he used to. Bandler's phone still rings during the wee hours when he's the on-call radiologist. Emergency-room physicians still call when they need someone to interpret pictures of an accident victim's brain or help them determine the severity of a stroke. When the calls come in, Bandler walks to his computer instead of his car. "I don't have to put on my pants and drive to the hospital to interpret results," he said. "I get up, blink my eyes a few times, and while I'm looking at the image on my computer, I'm talking to the technologists (in the hospital)." Minutes count in the emergency room because many patients have a better chance of recovering if treatment begins quickly. But a physician may want a radiologist to interpret pictures of a stroke patient's brain or an accident victim's insides before they begin treatment. Patients who need a speedy diagnosis are some of the first beneficiaries of teleradiology, a technology that uses computers to view and transmit medical images. Bandler and his colleagues at Medford Radiological Group use a network of computers and telephone lines to view and transmit images such as CT scans - cross-sectional images of the body laid out like individual slices from a loaf of bread. CT scans provide far more information than traditional X-rays. CT scans and other computer-created images lend themselves readily to transmission over telephone lines. Over the next few years, Southern Oregon hospitals hope to do away with X-rays and other film images, viewing and storing all kinds of medical images electronically. Eliminating X-rays and other medical films "would change the whole look of radiology in general," said Harley McCormick, lead computer-tomography technician at Providence Medford Medical Center. "Anytime we looked at an X-ray or a CT scan it would be computer-generated. A doctor who ordered (a scan) in Ashland would get on his computer and talk with the radiologist who did it." Assembling all the pieces of the film-free environment known as PACS (picture archiving communication system) will take years and millions of dollars. Providence hopes to make the conversion within the next 21/2 years. Asante Health System installed all-digital radiology equipment at its new Three Rivers Community Hospital in Grants Pass and plans to convert to digital radiology within three years at Rogue Valley Medical Center in Medford. The small network that local radiologists and hospitals already have built represents "one of the key pieces of the puzzle that will eventually become the PACS system," McCormick said. Transmitting CT images by computer becomes critical at night, when there are usually no radiologists in either hospital to respond to an emergency. Images transmitted to an on-call radiologist typically arrive in less time than it would take for the doctor to drive to the hospital. A brain scan takes about five minutes to transmit; a chest/abdomen scan arrives in nine to 10 minutes. Radiologists view the images at home on fairly ordinary, off-the-shelf computer equipment, Bandler said. "It's not the speed of the processor that matters. We have special software installed (to read the images), and it takes a little adjustment to make it run well, but you could use virtually any computer or any modem and configure it to run. "We use high-resolution monitors in our homes, but they're still monitors you might buy at a computer store." The software also allows images to be transmitted between computers at Rogue Valley and Providence. Physicians working at one hospital can view pictures from the other without driving across town. "We're back and forth all day," Bandler said. "I might be working at Providence during the day and they'll transmit something from Rogue if somebody comes in with, say, a head injury." Making the transition from looking at film pictures to images on a computer screen required little adjustment, Bandler said. "We're used to (reading images on a screen)," he said. "CT images come out first on a monitor. We often read them and review them on the monitor." The computers also give radiologists new ways to look at slices of the body. The computer can display the pictures in "cin�" mode, flashing each one briefly in succession to help the radiologist see small changes. "Being able to scroll up and down helps," Bandler said. The computer displays a single image on the screen instead of the multiple images that appear on film when CT scans are converted. "You get one big image instead of 15 small images on a piece of film," Bandler said. "That lets me concentrate on each image." The new technology allows one on-call radiologist to handle the growing case loads at Medford's two emergency rooms. "If we didn't have this now," Bandler said, "we'd have to have (a radiologist) stay in the hospital, but we'd have to be in both hospitals." It also gives the doctor on call a chance to get a little more sleep. "It's helpful because it keeps us moderately refreshed," Bandler said. "It's not unusual to get six to 10 calls a night." Reach reporter Bill Kettler at 776-4492, or e-mail [email protected] Mail Tribune Home | Ottaway Newspapers, Inc. | Dow Jones & Co., Inc. | Privacy | Contact Us Copyright � 2001 Mail Tribune, Inc.