From a Distance: Remote Imaging Solutions as a Response to Industry Needs

By Matt Skoufalos from "The Ice Community"

In a February 2022 whitepaper, the American Society of Radiologic Technologists (ASRT) described “a perfect storm” of factors contributing to a labor shortfall in the medical imaging and radiation therapy professions. These included an aging population that places greater demands on the health care system, a lack of incoming talent pursuing imaging careers and a swath of veteran staffers quitting the field for retirement or job changes.

The paper documented a 20-year high in vacancy rates – unfilled positions for which imaging employers are actively recruiting – led by a 19-percent vacancy rate in cardiovascular-interventional technology (CVIT), 18-percent vacancy rates in radiography and computed tomography (CT), and a 17-percent vacancy rate in sonography. Those rates have all doubled from sub-10-percent rates in 2021, and quadrupled from historic lows reported about a decade ago.

Among survey respondents, 70 percent reported staff turnover in their departments within the past year, in which nearly 81 percent of people departing went to work at a different facility, with 35 percent attributing their departure to burnout, “including emotional exhaustion and feeling unappreciated at work.” One-third of all respondents said that their workplaces had hired traveling staff to fill vacancies.

In response to these conditions and others, a number of imaging facilities are turning to remote scanning solutions and staff to resolve their throughput and workforce needs.

“Coming out of [the novel coronavirus] COVID[-19 pandemic], we were looking at the landscape of workforce availability, staff attrition, workforce replenishment and the need to address growing patient imaging volumes,” said Bruce Snyder, senior product manager in the Siemens Healthineers North America Education & Workforce Solutions business.

Of the $11 billion allied health staffing industry, Snyder pointed out that more than a quarter of its projected size for 2025 is attributable to the needs of the medical imaging space; or up to $4 billion.

Although the intensity of the demand around medical imaging staffing was most pronounced around the 2020 pandemic onset and in subsequent recovery years, vendors responded with technologies designed to pick up the slack for the future, including Siemens Healthineers’ syngo Virtual Cockpit. The software allows imaging professionals to support onboarding and mentoring of new employees, administration of advanced scans and upskilling and cross-training on diverse modality platforms. Perhaps the most significant advantage of remote scanning technologies, however, is that they allow qualified technologists to manage device operations from an offsite location, extending the expertise of a facility’s top resources to the broader team.

“Many of our customers are still enduring staff shortages,” Snyder said. “With remote scanning, you still need somebody at the bedside to position patients and administer contrast agents if the procedure requires them.”

“As long as that certified MR or CT tech with onsite expertise is in direct communication with the remote scanning tech, the remote technologist can be positioned elsewhere on campus or even on a different campus, scanning in,” he said. “In the syngo Virtual Cockpit, we’ve recreated the same things the customer would have in the cockpits of their own systems, with multiple viewing screens and various audio/video inputs.”

Remote technologists may connect with multiple systems in the same department, or at different sites in the same health system. They can participate in procedures involving as many as three scanners – each one at a time – independent of manufacturer, thanks to its high-speed networking technology.

“We have to run the device continuum,” Snyder said. “We don’t have full market share in every customer, and we need to be able to provide multi-vendor services With syngo Virtual Cockpit, when the question arises, ‘What about my GE, my Philips,’ they like that our solution offers interoperability.”

The earliest adopters of remote scanning solutions like syngo Virtual Cockpit are among Siemens Healthineers’ most “technology-forward customers,” as well as those who need to address either volume or staffing needs, Snyder said.

“Do you need expertise, or do you need capacity augmentation, or do you need both?” he said. “We’ve seen a combination of high-volume centers that need to be able to scan quickly and efficiently, as well as managing complex cases that come in.”

“A lot of imaging care is about how to move quickly and efficiently through patient volumes,” Snyder said. “There are still those prospective customers who are waiting with some trepidation, cautiously optimistic that it could be a solution for them, but aren’t ready to move forward yet.”

As remote scanning services continue to expand, vendors anticipate eventually delivering a level of support that would enable facilities to switch their scanning services fully to on-demand utilization.

“You can hold access to care quickly, readily and through a network,” Snyder said. “There are people who are interested in working as technologists, but don’t want to travel anymore. Some folks would be able to take on that role as contract specialists, so we can envision an accessible network of techs from around the country being brought to a virtual operations center. We anticipate remote scanning adoption increasing as its benefits become better understood.”

Amy Peronace, vice president of operations at RemoteRadTech, said that, in addition to facilitating a variety of diagnostic imaging work, remote scanning services also offer cost savings over other staffing solutions. Amid the decline in registered technologists entering careers in health care – or even the career training systems that prepare technologists for it – contract employees and traveling staffers command greater wages than every employer may be able to offer its hires.

“Freestanding hospitals and mom-and-pop shops are starting to see fewer technologists, particularly in the big, money-making environments,” Peronace said. “They have this high-end equipment with big overhead that they can’t staff. We are vendor-agnostic, which means we can provide staff trained on all technologies with the capability to operate any remote scanning platform that an institution has.”

RemoteRadTech registered technologists (RTs) are centrally located within the company hub in Florida, from which they can scan any offsite environment to which they’re connected, 24 hours a day. Their versatility and around-the-clock availability provides access to needed services for “that third shift, night shift, weekends, and holidays that they can’t get staffed,” Peronace said.

A critical component of the RemoteRadTech approach involves helping assuage customer anxieties about the mechanisms of offsite work. Remote RTs are overseen by a magnetic resonance imaging safety officer (MRSO), who performs a full evaluation of clients’ MR environments, trains their onsite staff to the comfort level of everyone involved in the work, and ensures that staff have been trained to work alongside technologists in a remote scanning setting. Before patients are allowed in the room, remote techs have access to their safety questionnaires and intake forms, as they are ultimately responsible for their welfare.

“Most concerns are just the unknown,” Peronace said. “What’s going to happen if the patient has a reaction? Our technologist always has communication with the person on the ground at all times. There are cameras on the control room that have eyes on the scanner, and can see the room. Level 2 onsite personnel should always have basic life support and CPR training, but if you have a situation, you’re calling 9-1-1 anyway.”

Critically, Peronace said RemoteRadTech staff deliver their services to whatever the comfort level that the client requires. During rollout, they’ll remain onsite “for weeks if that’s what it takes,” she said.

“When radiologists started reading remotely, it took a long time for people to get accustomed to that,” Peronace said. “Remote scanning is now going to be the norm. RemoteRadTech is here to address the challenges that we have, and amplify the efficiency of those MR scanners. We’re not coming in trying to change anything; we’re focusing on being a part of it. Our technologists are part of your team – they’re just sitting someplace else.”

The relief that remote technologists can offer medical imaging facilities isn’t limited to reduced overhead, additional scheduling flexibility and improved patient throughput. Offsite professionals can also provide a measure of relief to onsite technologists who may be struggling to meet the demands of an overworked diagnostic imaging department and ever-growing patient volumes.

“Directors are seeing their staff overworked, overtime and stressed out trying to do more patients in a day,” Peronace said. “Sometimes they’re paying the traveler $100 an hour to run these shifts. We’re able to save them money, and we can provide a return on investment (ROI) calculation after a three-month overview. Plus, for a lot of these remote centers that can’t pay to get techs, they don’t need somebody to move to work there.”

For 3T Radiology and Research of Miami Beach, Florida, the value of remote scanning technologists isn’t entirely related to cost savings, nor to a staff shortage, nor to the provision of diagnostic imaging services. As an imaging center focused on supporting clinical researchers by providing high-quality imaging studies, 3T co-founder Humberto Carrion said his business’ four freestanding clinics rely on RemoteRadTech for the quality of its technologists and the ability of remote scanning to free up onsite staff to provide a higher quality of bedside care.

“I didn’t get remote techs because of staffing issues,” Carrion said. “We have a good reputation in the area, and our techs like working here because we support a lot of research that gives us the opportunity to do different types of scans.”

“The main reason I use RemoteRadTech is because of the efficiency it brings,” he said. “No matter how much we prepare our patients, sometimes they have new questions or anxiety once they enter the scanner. Now what happens? An onsite tech aide puts the patient on the table, closes the door and has a full 10 to 15 minutes to interact with the patient because the remote technologist is performing the scan. That’s the biggest thing: we’re a boutique, high-end facility, and we give higher-end service.”

Patients enrolled in clinical trials may be dealing with complicated health conditions that are painful, emotionally exhausting or can interfere with the study as it’s captured. The ability for 3T staffers to deliver a higher quality of care at the patient bedside not only puts at ease those patients who might need a little more attention, but it also allows the offsite technologist to capture the best possible image for clinical researchers who need high-quality data. Moreover, the Level 2 technologist onsite is freed up to devote the most attention to the patients who need it.

“The tech aide focuses on patient experience, and the tech who’s remote focuses on the scan,” Carrion said. “The tech aide can say, ‘Would you like me to stand where you can see me, place my hand on your foot, be here with you?’ The tech aide can be present to the patient at all times, which prevents nervous people from walking out. They just need to have L2 training and be good with people. Many of my Level 2 technologists are nursing students, MRI students and paramedics.”

The efficiency and outcomes have been such a win for 3T that Carrion said each of its four locations will be converting its RTs to remote rad techs.

“From a business perspective, there’s a slight cost savings, but it’s more about the output,” he said. “The time elapsed between one patient and the next has completely shortened. We do more patients per hour than ever before because there’s not that lag.”

“What we realized was having tech aides in-house and two remote scanners became kind of like a concierge experience,” he explained.

3T began working with RemoteRadTech when it partnered with GE as a pilot tester of that company’s nCommand Lite remote real-time scanning support solution. Carrion first thought it might be useful to have remote RTs in emergency circumstances, but once the software cleared its U.S. Food and Drug Administration (FDA) approvals, GE became its authorized distributor in the United States, and 3T began using the app full time.

A GE HealthCare news release from the 2024 RSNA conference in Chicago explains the capabilities of the nCommand Lite solution.

“nCommand Lite by IONIC Health empowers radiology staff to focus on patient care, while accessing the support needed through remote collaboration and scan assistance. nCommand Lite includes multi-modality capabilities in support of magnetic resonance (MR), computed tomography (CT) and positron emission tomography/CT (PET/CT) scanning,” according to the news release.

“RemoteRadTech is the full solution,” Carrion said. “They get you all the IT infrastructure you need, they set everything up, and they have an MRSO and train the tech aide on the safety procedure to make sure everything goes smooth. I don’t have to find software, lag time, an MRSO to train my tech aides, or a tech who’s willing to be in a remote location scanning multiple scanners at once.”

Original publication: https://theicecommunity.com/from-a-distance/