International Standards In Radiology

The practice of radiology is changing with globalization of healthcare, corporatisation of radiology providers and possible commoditization of radiology services. Radiologists and professional organizations are committed to the professionalism principles and the need to promote and improve the quality of care and patient safety. They will play a leading role, engage the consumers, referrers, insurers, regulators and payers and set quality frameworks to ensure service delivery models are in the consumers' best interest.

National Standards in Radiology

International Clinical Teleradiology Standards

National Standards in Radiology

National radiology-specific accreditation programs are currently available in the United States from the American College of Radiology, American Institute of Ultrasound in Medicine and the Inter-Societal Commission for the Accreditation of Vascular Laboratories; in Australia from the Royal Australian and New Zealand College of Radiologists and National Association of Testing Authorities; in New Zealand from the International Accreditation New Zealand, in Korea from the Korean Institute of Accreditation in Medical Imaging and in Finland from the Radiation and Nuclear Safety Authority. Generic quality management accreditation is available through the International Organization of Standardization (ISO) agencies.

While there are radiology-specific standards supporting these national accreditation programs, a set of internationally developed standards in radiology does not exist. However, it is a matter of time when there will be a need for common international standards for benchmarking and to enable cross boundary recognition by insurance funds and consumers. ISO has a range of international accreditation standards. ISO Standard 9001 is the most commonly used standard and is applicable for the assessment of a quality management system. ISO/IEC Standard 17025:1999 'General requirements for the competence of testing and calibration' is a generic set of standards for the assessment of 'testing'. Using ISO/IEC Standard 17025 as a template, a draft standard 15189:2001 was developed specifically for the accreditation of pathology laboratories. Based on the pathology model, consideration may be given by the radiology profession to the development of a set of internationally recognized standards in radiology.

Notwithstanding the merits for these standards, there are real challenges and barriers along the way. These include: funding, time needed for development and adequate consultation, radiologists' input, organizational resources, commitment and turn over of personnel. The IRQN is optimistic that as a result of the dedication and interest of the radiologists and the commitment of the member organizations, it would be possible to maintain on-going interest, commitment and leadership and achieve this important task in the coming years.

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International Clinical Teleradiology Standards

Clinical radiology is undergoing rapid change due to new diagnostic and interventional techniques, workload increase and workforce shortage. Globalization of healthcare, telemedicine and technological advances such as Picture Archive and Communication Systems (PACS), faster internet connections and more secure Virtual Private Networks are facilitating the growth of international clinical teleradiology.

During the International Society of Radiology - sponsored World Leadership Council meeting in 2004, a resolution was passed that the profession should work towards a set of uniform international standards for clinical teleradiology. The meeting suggested that IRQN was an appropriate body to coordinate this development by taking into account the work already undertaken by the ACR, CAR, EAR, RCR, RANZCR and other organisations. It was recognised, however, that this would be difficult and it needed to be appreciated that there would be varying levels of service, reflecting the available resources and stages of technical and professional development of teleradiology within different countries.

It was agreed that an initial realistic approach might be to develop broad-based principles from which guidelines and standards could be developed over time. To facilitate this, an IRQN International Clinical Teleradiology Standards Workgroup was formed in 2005. The Workgroup's task was to: review the literature, develop broad principles and consult the stakeholders. The principles would cover the key elements and when approved would guide the drafting of more detailed Standards. It was intended that these drafted Principles would be rectified in 2007 and published in the website for feedback. Forming an integral part of this project, the Workgroup would develop a framework to accommodate the differing needs of the developing and developed countries as well as local requirements. For example, under a mutli-level framework of a set of uniform standards, individual countries could participate initially at an achievable / entry level and would progress towards an uptake of the full set of these standards, over time.

The IRQN ‘Top 10 Principles of International Clinical Teleradiology’ was approved by the members during the 2008 meeting in Vienna. The network recognizes that this draft is an evolving document and would be refined over time. These principles are now available for perusal and comments. Feedback could be forwarded to the International Clinical Teleradiology Standards Workgroup via: irqn@ranzcr.edu.au.

Click Here to view the IRQN draft Principles of International Clinical Teleradiology.

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