Statement on the Interpretation of Radiology Images Outside the United States
Updated statement as of 5/8/04
Last summer, E. Stephen Amis, Jr., M.D., chair, American College of Radiology (ACR) Board of Chancellors, convened the ACR Task Force on International Teleradiology to discuss legal, regulatory, reimbursement, insurance, quality assurance and other issues associated with this new and emerging practice. The use of teleradiology and its ability to transmit radiological images electronically from one location to another, outside the borders of the United States, has made this a prominent issue for the profession and the College. The task force will submit a report to the ACR Council in May 2004.
The ACR has become aware of several recent statements in the national and local media that promote outsourcing or sending of imaging exams of patients in the United States for interpretation in foreign countries. However, these statements have omitted a number of important conditions that are necessary to protect patients and to ensure the delivery of high quality radiological care.
As the leading organization for medical radiology dedicated to ensuring quality patient care, the ACR is very concerned about the implications of overseas radiology and its potential effect on patient care in the United States. The ACR believes that physicians who interpret images by teleradiology should meet or exceed the same standards met by physicians practicing within the United States. Certification and Maintenance of Certification by the American Board of Radiology is the best means for the health care consumer to judge the qualifications of the radiologist. To achieve these standards, physicians who interpret images by teleradiology shall: (1) be licensed to practice medicine in the state where the imaging examination is originally obtained as well as possess any medical or other licensure required within the jurisdiction of the interpretation site; (2) be credentialed as a provider and maintain appropriate privileges in the health facility or hospital in the United States where the examination was obtained; (3) have appropriate medical liability coverage for the state in which the examination was obtained; and (4) be responsible for the quality of the images being interpreted. Physicians practicing outside the United States must willingly agree to submit to the jurisdiction of and be completely accountable to all applicable state and federal laws in the United States.
Radiology groups, hospitals and other entities in the United States should enter into contracts for interpretation of imaging examinations provided from outside the United States with only those physicians who meet the foregoing criteria. Those criteria require that they possess the appropriate licensure, liability coverage, credentials and hospital medical staff or other health care facility privileges.
Patients in the United States expect high-quality care and service from fully licensed and accountable medical practitioners. Patients also have the right to expect that all physicians who are providing their care, including radiologists, are practicing with a high level of skill and safety as provided by meeting state licensure and hospital credentialing requirements. Patients also expect that their physicians will be subject to all state and federal laws governing the practice of medicine and held accountable for their actions. As physicians, we must insist that all physician services be held to the same high standards to ensure the absolute best for our patients.