Teleradiology from primary care: comparison of user activity in two different scenarios.

We recorded the activity over one year of users of two identical teleradiology systems installed at different primary care centres. In one centre, which generated 3711 cases, the process was conducted according to the decisions made by the general practitioner (GP); in the second, which generated 3786 cases, the radiologist at the referral hospital controlled the process. In a one-year study, the number of studies created, transmitted and interpreted per day was similar in the two scenarios (14.3 vs 14.6, respectively); however, there were considerable differences in the number of images (2.2 vs 1.8, respectively) and folder volume (19.2 vs 14.3 Mbyte, respectively) per study. Also, there were differences in the time taken to create the patient folders (4 min 35 s vs 2 min 55 s, respectively) and the time taken for the radiologist to diagnose a case (3 min 32 s vs 2 min 47 s, respectively), which may be important at high workloads. The radiologist-driven scenario included 64 rejected requests (1.6% of cases) and 280 studies in which additional images were required (7.4% of cases). Whenever it is possible to choose, the radiologist-driven scenario for teleradiology appears to be preferable. A prerequisite for successful teleradiology is the availability of appropriate bandwidth and operational protocols.