Teleradiology company helps solve radiologist shortage in Brazil

For ordinary Brazilians, access to adequate healthcare is a bit of a challenge. According to a Deloitte report [PDF], it is estimated that the country has 2.5 hospital beds per 1,000 people. The quality of the care received is questionable too. A 2014 survey showed that 93% of Brazilians think healthcare services in Brazil are “poor or terrible”.  

A big part of the problem is inadequate access to healthcare in poor and remote areas. For the elderly population, this is also a growing concern. According to the World Health Organisation, currently the elderly population stands at 14 million, but is forecast to reach 49 million by 2050. This means that it has become even more important for the elderly to have appropriate access to healthcare.

Telemedicine is a growing area in Brazil and offers the opportunity for doctors to send images securely over the internet to specialists located in remote areas for them to diagnose and treat patients. Telelaudo/Pró-Laudo is a teleradiology company that is helping to solve this problem by sending radiology reports to imaging centers and hospitals in remote areas.

We speak with the Co-Founder, Alexandre Ribenboim via email to find out more.

Is there a shortage of radiologists in Brazil?

In the last [few] decades, the technology behind radiological equipment has undergone incredible changes: from the image scanning capability that experienced an increase in the speed at which the equipment [can] perform the scans, to the accuracy of the images and also the emergence of several new techniques and new modalities. Consequently, the number of studies increased tremendously, not only in Brazil but in the world, and therefore there's always many studies to be read. In the specific case of Brazil, besides the uneven distribution of radiological equipment, there is also an uneven geographical distribution of radiologists, who prefer to live in large urban centers, leaving many provincial cities unattended.

What does Telelaudo/Pró-Laudo do and how does the technology work?

We are a teleradiology company. We receive thousands of scanned radiological images through a secure data network of more than 300 hospitals and imaging centres throughout Brazil. These are analysed by our team of radiologists and then made into reports and returned to the hospitals. We do this 50,000 times a month.

What specific technological equipment do you use?

[At the hospital] there must be at least one digital radiological equipment - MRIs, Tomographs, X-Rays, or others. The radiological equipment has to be connected to the internet through a router with VPN protocols in order to transfer the patient’s images and receive the reports on a secure connection.

On our side, the radiologists that read mammography studies need special monitors with high resolution. We also use specialised microphones for voice recognition. And high reliability servers (we can't go off!) to manage the studies/report workflow.

How did you get these radiologists on board?

We have a tight process for selecting new radiologists to our team. First we do an analysis of their curriculum vitae to check if they are working for or have worked for a prestigious hospital or imaging centre and for how long. Then we do a background check by talking to some of their collegues and bosses to assure that they have a good track record. Finally we interview them to evaluate their technical skills and see if they have what is necessary to work from home. Every new radiologist stays for some months in a probation period during which we review most of their reports.

How does this service improve healthcare in Brazil?

In rural areas, where access to the radiologist is [difficult], it’s clear how much our service helps in improving Brazilians' health. Today, we serve hospitals in cities of 20,000 inhabitants that have only one radiologist in the region, not always qualified to read all kinds of studies. For a region like that, our teleradiology service enables the population to have access to studies that previously were not possible. Moreover, our contribution is also clear in the larger centres, particularly in hospital emergencies, where we reduce the turnaround time of reports.

What sorts of challenges do you face?

We are delivering around 50,000 reports per month and in order to handle this huge number, the workflow becomes very complex, for example to route studies among different subspecialties of the radiologists. At all times, our systems are instantly answering the following question: what radiologists are currently available that are qualified to read this study? We use technology such as speech recognition, to bring efficiency to the radiologist, especially for those who work with emergency studies, whose reports have to go back to the hospital in a few minutes to help save lives.

What are some of the problems with healthcare in Brazil today?

The biggest challenge for a country as large as Brazil, with more than 200 million people, is to scale the network of health providers and to build and deliver quality services to each and every region. In the specific case of medical specialties that rely on advanced equipment, such as radiology, the distribution is very uneven, with most of the equipment concentrated in the southeast and the south regions and in large cities.

What sorts of technology are you excited about that you think has great potential in improving healthcare in Brazil?

All telemedicine services that will shorten distances and provide cheaper access to health care in a country as large as ours have the potential to profoundly impact the health of the Brazilians. Teleradiology, within other medical specialties, like Telecardiology, is the most developed and with large impact for now, but other important areas are emerging as online consultations and wearables technologies for health monitoring of chronic patients and the elderly.

How do you see telemedicine shaping healthcare in the coming years?

Especially for a country with distances and complexities that Brazil has, telemedicine has already brought and will increasingly bring more impact to the health of Brazilians from all the corners of the country. [The fact that it will] enable access to a specialist doctor or a radiological report to a patient, regardless of where he or she is located is transformative. The country has realised this and is investing in a university network of telemedicine, called RUTE that will help in shaping public policies.


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Ayesha Salim

Ayesha Salim is Staff Writer at IDG Connect

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