Better, Faster, Cheaper 2

Teleradiology cheaper, faster and of good standard

IN THE letter, 'Isn't it cheaper and better to have in-house radiologists?' (ST, March 3), Dr Shoen Low Choon Seng asked if it would be cheaper to station a radiologist at Ang Mo Kio (AMK) Polyclinic, rather than outsource reading of X-rays to Bangalore, India, via teleradiology. It would not be cheaper. With 700 X-rays per month, his proposed arrangement would cost AMK more than $30 per X-ray just to cover the radiologist's salary. This is much more than AMK pays India.

As a trainee radiologist, Dr Low should know teleradiology has a proven track record and has brought sustained benefits to many patients in hospitals in the United States. It is not merely cost savings, but more important, faster turnaround time and often even better quality reports. Our brief experience so far has already demonstrated these benefits.

Dr Low raised the issue of legal liability. This is important in any outsourcing arrangement. It was fully and satisfactorily addressed in the US, even within the strong culture of medical litigation there. The key is to ensure that the appointed provider is appropriately accredited.

In this case, an assessment was carried out thoroughly. The Ministry of Health appointed the College of Radiologists as the accreditation body to determine the provider's suitability. The college conducted a site visit in Bangalore to assess the facilities and processes, and found them to be good. The college also noted that the provider was accredited by the Joint Commission on Accreditation of Health Care Organisations, the largest accrediting body on health care in the US. The college further tested the provider's proficiency and was satisfied with its standards.

The National Healthcare Group, which runs AMK Polyclinic, is legally accountable to its patients for the quality of its radiological services, including X-ray reports that are outsourced. Indeed, doctors are not new to cross-border consultation. Occasionally, doctors send tissue samples overseas for reading by foreign pathologists. Doctors who do so remain accountable to their patients here.

The delivery of health care will continue to be further globalised as a result of technology and the Internet. This opens up many opportunities. We should be alive to such opportunities, so we can bring such benefits to our patients, as pointed out by Mr Paul Chan Poh Hoi in his letter, 'Outsourcing is the right way to cut costs' (ST, March 4).

Teleradiology and any kind of outsourcing need not necessarily take place across borders. Our public hospitals and polyclinics will readily outsource reading of X-rays to local radiologists, when they can offer a similar or higher quality service as Bangalore at lower cost. Such competition will be good for our patients.

Karen Tan (Ms)
Director,
Corporate Communications
Ministry of Health



Added:

Globalisation of healthcare in the form of teleradiology and employment of 'foreign' healthcare workers has a very real human cost.

When you build a factory or an industrial park in a Developing Country, you provide employment for people who might otherwise be unemployed. When you employ trained healthcare workers to work for you rather than their own countrymen because you can pay them more, I think ethics come into the picture.

You are getting cheaper X-ray reports, nurses and doctors, they are losing essential healthcare workers.

Dr Crippen calls it 'exporting our healthcare problems'. It doesn't sound as grand as 'globalisation', but I think it gives a new perspective to 'progess'.