Teleradiology and emerging business models.

A number of new diagnostic radiology services have emerged which use teleradiology. The main themes include: (1) stand-alone teleradiology practice; (2) the "Nighthawk"/on-call coverage; (3) solo radiologist practice; (4) expert/second-opinion teleradiology; (5) a global virtual radiology service based on workload sharing and reallocation. More applications of teleradiology can be expected due to the continuing shortages and uneven distribution of radiologists, and the increasing use of radiological imaging for diagnosis. In a large enterprise, such as the US army, teleradiology will allow the creation of a global diagnostic organization where diagnostic images are distributed according to the availability of radiologists. Eventually the distinction between picture archiving and communication systems and teleradiology will be blurred and radiology will be provided by virtual organizations with distributed capabilities. As teleradiology services claim a bigger share of radiology practice, various legal and regulatory issues will need to be solved. Ultimately the successful business model will depend on the ability to produce the highest-quality product at the lowest cost.