As many radiologists find themselves working from home or remotely, the American College of Radiology® (ACR®) is here to help with recommendations for best practice to deal with the current situation. The ACR White Paper on Teleradiology Practice was published in 2013 and many of its principles still hold true today. One note, the Teleradiology White Paper describes the interpreting radiologist being licensed at both the sending and receiving site and there has been a temporary relaxation of that requirement by many states and the Federation of State Medical Boards during the COVID-19 crisis. The ACR has provided a summary of these newly issued CMS rules.
Highlights to remember in these times are the need for physician-to-physician communication and the need to remain visible as you are a critical part of each patient’s care team. Collaborative tools may be directly built into workstations or provided by your institution. Before using online meeting solutions (e.g., Skype, Zoom, etc.) for clinical or administrative conversations, you should check on guidance for recommendations from your enterprise IT team regarding HIPAA compliance and other considerations.
Be careful to look after your physical health — not just the obvious threat from infection, but fatigue and repetitive stress injuries that can be addressed with a well-designed work environment focused on ergonomic factors. Ensure lighting, temperature and noise are considered for maximum comfort. Radiologists can use SMPTE patterns or equivalent to assess the impact of their lighting conditions and to perceive changes in detection of spatial (line pairs) and contrast (box-in-box) resolution with ambient light changes. Ensure that viewing stations for reviewing mammographic images specifically remain compliant with the Mammography Quality Standards Act. For more information on technical details, refer to the ACR-AAPM-SIIM Technical Standard for Electronic Practice of Medical Imaging.
Ensure that you continue the practice of including relevant prior imaging and medical record information as correlative information in your interpretations. This information should remain available to you in your remote workspace. All efforts should be made to ensure meaningful comparison regardless of setting. This may require that studies be pushed or pulled to the remote workstation prior to review for optimal performance, especially in times where internet bandwidth is at a premium.
Remember that communication with the technologists is critical as they remain under the supervision of the radiologist even while in the work from home situation. Ensure that you have the ability to contact the technologists or sonographers, and they have the same ability to contact you.
Be safe for yourself, your families, your fellow members, your colleagues in health care, and the communities you serve.