1. Commercial Teleradiology Interpretation of Musculoskeletal (MSK) MRI Studies: Educational and Financial Rewards for an Academic Radiology Department Joe Lacy M.D. MBA, Greg Chaljub M.D., Randy Ernst M.D., Elizabeth Jones M.D., Aytekin Oto M.D., Leonard Swischuk M.D.

2. BACKGROUND Academic Radiology Department State University Medical Center Indigent Population State Departmental Budget Cuts

3. TELERADIOLOGY Texas Department of Criminal Justice Texas Department of Criminal Justice Antarctica Antarctica Cruise Ships Cruise Ships NASA NASA

4. DEPARTMENTAL OPPORTUNITY Commercial Imaging Center Required Radiological Interpretation Commercial Imaging Center Required Radiological Interpretation Expertise Expertise Prior experience with teleradiology Prior experience with teleradiology

5. PURPOSE To evaluate the principle effects of a commercial venture interpreting images from outside MRI imaging centers.

6. MATERIALS AND METHODS Total number of intrinsic and extrinsic MSK MRI studies volume from 2001 through 2004 was queried via Radiology Information Systems and compared.Total number of intrinsic and extrinsic MSK MRI studies volume from 2001 through 2004 was queried via Radiology Information Systems and compared. A new MSK MRI rotation was established.A new MSK MRI rotation was established. Residents were surveyed regarding MSK MRI rotation participation and confidence in interpreting MSK MRI.Residents were surveyed regarding MSK MRI rotation participation and confidence in interpreting MSK MRI. Limited financial statement interpretation was performed specifically targeting budgeted departmental revenue changes and return on investment.Limited financial statement interpretation was performed specifically targeting budgeted departmental revenue changes and return on investment.

7. RESIDENT SURVEY 1. Have you rotated through the MSK MRI rotation? 2. Did participation in the MSK MRI rotation improve your confidence reading MSK MRI?

8. RESULTS INCREASED MSK MRI Volume make a graph

9. NEW MSK MRI Rotation No dilution of teaching. No dilution of teaching. No increased FTE’s No increased FTE’s

10. RESIDENT SURVEY 16/27 Residents rotated through MSK MRI. 16/27 Residents rotated through MSK MRI. All 16 reported INCREASED CONFIDENCE READING MSK MRI All 16 reported INCREASED CONFIDENCE READING MSK MRI

11. Targeted Financial Analysis Implementation Costs Hardware (specific) Hardware (specific) Contract Networking Costs Contract Networking Costs Payback Period - Less Than 1 Year. Return Exceeded Risks!

12. Targeted Financial Analysis Projected Teleradiology Revenue Exceeds 10% of Budgeted Departmental Revenue Teleradiology Collection Rate = 100%

13. combone Increased MSK MRI Volume Creating a New MSK MRI Rotation. Increased MSK MRI Volume Creating a New MSK MRI Rotation. Increased Resident ConfidenceIncreased Resident Confidence No Dilution in Teaching.No Dilution in Teaching. Increased Departmental Revenue Increased Departmental Revenue No Service Decrease or Employee LossNo Service Decrease or Employee Loss No Additional FTE requiredNo Additional FTE required

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17. combne Increased MSK MRI Volume Increased MSK MRI Volume Increased Resident Confidence Increased Resident Confidence Improved Professional Skills Improved Professional Skills Increased Departmental Revenue Increased Departmental Revenue No Service Decrease or Employee Loss No Service Decrease or Employee Loss No Additional FTE required No Additional FTE required

18. Combine = conclusion The result is improved resident clinical training to interpret MRIs and meet client expectations while simultaneously improving departmental financial goals. The result is improved resident clinical training to interpret MRIs and meet client expectations while simultaneously improving departmental financial goals.