VoiceIt: "Creating the teleradiology business case"

(HealthTech Wire / VoiceIt) - Radiological expertise is disproportionately distributed throughout Europe: some regions are well catered for with radiologists, while others are suffering from an acute shortage. To address this imbalance, the European R-Bay project was initiated. It offers a secure IT platform for the exchange of DICOM images both within a country and in cross-border scenarios. HealthTech Wire talked to Ulf Andersson, Director of Marketing and Business Development at Carestream Health, about the project. R-Bay will also be presented at the European Congress of Radiology in Vienna (March, 6-10) in EXPO B.

Published: 03/02/2009

Could you describe briefly what exactly the R-Bay project is and which partners are involved?

R-Bay is an EU-funded project set up to investigate a pan-European eMarketplace in radiology. It was approved for funding in the context of the European Union’s eTEN program in 2007 and works with a budget of approximately €2million. The project is coordinated from southern Denmark, where the idea of an eMarketplace for radiology was initially developed, and involves seven hospitals from the Czech Republic, The Netherlands, Estonia, Norway, Lithuania and Finland. And there are two industrial partners in the consortium, Carestream Health and Mawell. Carestream is responsible for the technical infrastructure, while Mawell offers additional services, for example deployment services.

What are the results?

The results are pretty straight forward. It works. And it is considered a very attractive service by the hospitals involved. Technically, the R-Bay platform uses a streaming technology that was developed by Carestream Health. Using this technology, high-quality DICOM images can be transmitted almost irrespective of bandwidth. All a hospital needs to participate is an RIS/PAC solution from any company and the ability to communicate electronically. A standard broadband connection will do.

Why is there a need for a European eMarketplace in radiology?

We all know that there is increasing monetary pressure on healthcare systems everywhere in the world. The number of chronic diseases is rising and, in parallel, there is often a fall in the number of healthcare professionals. In radiology in particular there is a severe shortage of experts at least in some countries or regions in Europe. So the question that we started with was how can we make sure that we can provide high-quality healthcare in radiology regardless of where a hospital is situated?

Teleradiology is not actually a new technology. What is the specific advantage of having an eMarketplace for this purpose?

I think there are several advantages. One is that R-Bay offers a platform where institutions in a position to offer radiological expertise and institutions that are looking for such expertise can easily meet. They can use the platform to negotiate conditions and even to carry out payment transactions. The platform provides two ready-to-use contracts, one between the hospitals and the R-Bay platform provider and one between the two institutions that are cooperating. So the whole process of looking for and establishing a teleradiology partnership is made significantly easier. Another aspect is that by using a platform that is independent of both parties, independent quality control becomes possible.

Legal uncertainties are a problem for teleradiology services, in particular in cross-border scenarios. Is the R-Bay project also tackling these issues?

Legal problems are being addressed. We have several legal experts involved in the project. There are two important issues here. One is legislation in the countries involved. We have to ensure that teleconsultations are not illegal per se. This is an issue which the European Commission has repeatedly addressed and continues to do so. The other aspect is what is agreed between the two parties in a teleradiology scenario. This is important when it comes to liability, for example. Such issues can be addressed bilaterally in the contracts that the R-Bay platform provides.

What is the business case for an eMarketplace in teleradiology?

This is indeed an open question. Possible business cases are currently under discussion in the last phase of the project. The final report will be submitted to the European Union in spring or early summer. The issue of business cases will be addressed in this report. Possible scenarios include a platform that is run by a national or international institution on a non-profit basis. A commercial platform would, of course, also be an option. In this case, the transaction partners would have to compensate for the costs, similar to eBay, for example. It is clear that we as Carestream Health are not aiming to act as a provider of eMarketplace services. We are providing the technology, this is our key interest.

What will happen to the existing R-Bay network once the project has been completed in a few months' time?

The answer to this question obviously relates to the issue of a business case. The hospitals in the consortium have made it clear that they would like to continue to use the platform for teleradiology services. This is not surprising, since many of these hospitals are in regions where radiologists are indeed thin on the ground. What we are trying to do at the moment is to draw attention to the fact that this service exists, for example by presenting the platform at the ECR meeting in Vienna in March. It would not be difficult to scale up the platform in any order. And an increase in user numbers might make it easier to find a proper business case in the long run.

Mr. Andersson, thank you for your time and answers. (HTW)

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This is a HealthTech Wire VoiceIt interview.

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