What is Democratisation of Diagnostic Space?

Patients and doctors use multiple channels for getting better or discounted MRI or CT scans. However every-time, the patients or referring doctors ask a single question- 'How do I trust the given MRI or CT report or do we have a choice to get the best MRI or CT reports'? TeleradiologyHub Analytic says," This question from patients asks for democratization of diagnostic space." Opening seekers to a new world of radiodiagnosis with reporting choices is fundamentally a step towards democratization. 

Today, the diagnostic ecosystem is growing at a significant pace due to the advent of new machines and technology tools. The growing ecosystem has nucleus around people skills but sadly, the space is characterized by loose interaction between stakeholders. Stakeholders are people who do their roles in the diagnostic value chain. To understand the process of democratization, we need to find and analyze the stakeholder. In radiodiagnosis, they can be classified in three groups:

A. Seekers: Patient & Referral Doctors, Hospitals
B. Facilitators: Diagnostic Centers, Technologist, Aggregator Platforms
C. Providers: Radiologists, AI Engineers, Data Scientists

All three groups mutually coexist. Every stakeholder has different priorities or attributes. Due to limited freedom of choice and communication, space is unilaterally controlled by a few stakeholders. TeleradiologyHub Analytics had interviewed multiple stakeholders to know the status of actual outcome control and hurdles in patient choices. Uniquely, some second opinion platforms were the first to put service satisfaction in the diagnostic space. With their surveys and interviews, they also found that stakeholders were at cross-roads. The process of defining the service satisfaction itself is very convoluted right from generating hypotheses to action points. TeleradiologyHub team enlisted a series of priorities or attributes for different stakeholder groups and used an analytic method (ranking method) to find out commonly impacting attribute groups. Following mother triplet attributes were identified:

1. Time
2. Budget
3. Quality

 How do we explain the attributes in the Diagnostic Ecosystem that are highly ranked?

Firstly, all stakeholders expect proper turn around time (TAT) of MRI or CT or X-rays. Not less, not more. Radiologists insist on more time for detailed studies whereas patients want it as early as possible. The job of diagnostic facilities is to make patients understand the value of time Vs quality Depending on the complexity or the case and modalities the timings or turn around times (TAT) of the reports are told by diagnostic facilities.
For example: Xray Chest may be said to take 30 min whereas CT contrast study of Abdomen could take 3-4 hours in ideal settings.

Secondly, all stakeholders are budget conscious this or that way. Whereas, Diagnostic Facilities rever their profit margins because they have employed the capital in diagnostic set-up. On the other side, patients like to migrate to less budget diagnostic services. Major cost in the diagnostic process is apportioned to the scanning process due to fixed costs. Radiologists work on variable (fees or salaries) costs and want the worth of their skills and times hence demand better remuneration. Whether fixed or variable monetary expectations exist from both sides and MRI or CT Scan pricing is worked out. These days the aggregator platform provides volume leads to diagnostic centers. Sometimes the platform passes on benefits of scales or discounts to patients. Excessive ROI focus and increased volume of patients does put an unwarranted load on existing capabilities of diagnostic facilities affecting the delivery of reports itself.

Lastly, every stakeholder minds quality report. The quality of MRI or CT or Xray reports is a subjective area. However, the role of radiologist is pivotal as rest other processes including that of scanning process is more or less standardized. Moreover, patients have less to do with technical understanding of Dicom resolution as is important for reporting radiologists. Patients may differentiate 1.5 Tesla MRI machines or expensive 3 Tesla MRI machines but can not know the difference of reports coming from both the machines. It's a radiologist's job to give right reports. Radiologist if salaried needs to act on behalf of the employer. He may or may not ask for high resolution dicom images given the machine's limitation. Reporting is, therefore, an area where acute experience and skills are always required on old or new or different machines. Even normal reports could have chances of misread as stated by RSNA. As of now the radiology diagnostic process is highly controlled and undemocratic forming a close loop between patients-diagnostic facilities-radiologists.

"Transforming the existing Diagnostic Close Loop System to Open Democratic feedback loop system is a great way to impact the diagnostic outcome. In a highly loaded ecosystem, this innovation can deliver many smiles in distant areas. Time and budget is also important but quality is utmost important in healthcare setting". Customer Engagement reviews of TeleradiologyHub Second Opinion process suggests the same ( TrustPilot Review)"

Dr A.B. Kelkar, a senior radiologist from TeleradiologyHub

Stakeholders are slowly pushing to democratize the diagnostics process, meaning radiology reading skills can be imported anytime from outside instead of remaining captive to diagnostic facilities. Alternatively. It's a great way to have a check on reporting quality and reward super skills in radiology. Diagnostic facilities can get access to such online platforms which form a skill pot, especially when in-house radiologists are not trained or skilled in particular study/modality that gives confidence to patients and radiologists, alike. This guarantees a push to service satisfaction during the diagnostic.

TeleradiologyHub Analytics has found that with every second opinion, the quality focus around reporting increases - keeping Turnaround Time (TAT) in check. There is an additional budget requirement for a second opinion, but it is worth. Sense of relief is also sense of satisfaction derived with a presumption that ' I have opted for a choice of reporting panels at any given time'. As per TeleradiologyHub, in many parts of the world second opinion is turning out to be a thumb rule. The benefits are invisible but enormous. Example: It helps Ortho Surgeons to conduct the surgery with confidence. Oncologist to recommend chemotherapy or radiation therapy with precision.,

Conclusion: 
Yes. You can ask for a better report from your choice of radiologists. But someone needs to bring you the database of highly skilled radiologists and their genuine reviews. You may have got your MRI or CT scans from anywhere but in new Flemings' world, you can get the best radiology opinion that too from multi-Panel. If you do so, you are entering a beautiful democratic diagnostic world.