Facing a shortage of radiologists, the Maharashtra government plans to set up teleradiology centres in rural and tribal areas to digitally share X-rays, CT scans and MRI reports of patients with experts at the nearest centre in the state. The central government envisages a greater role for private healthcare providers in the industry, especially in regions where government facilities are poor.
According to the Directorate of Health Services (DHS), the decision to outsource radiology services to private players was taken due to continued shortage of radiologists in rural areas. Maharashtra has over 500 centres that offer X-rays but only 125 radiologists to analyse the reports. Under the proposal, the state government will provide technicians and X-ray machines while a private company will provide digital scanners to send reports to a central diagnostic laboratory, where a radiologist appointed by the company will study the reports and submit findings to the doctor treating the patient.
In areas with proper data connectivity, radiologists will directly send reports to doctors through email or mobile phones to facilitate immediate treatment.
“The tender in this case is yet to be floated. We plan to pay the vendor per X-ray scan conducted,” said Dr Satish Pawar, joint director at the National Health Mission in Maharashtra. According to Mohammad Ameel, senior consultant with National Health Systems Resource Centre in New Delhi, a pilot project was conducted to assess teleradiology’s impact in two villages near Bengaluru. “Based on that, we plan to formulate guidelines. Different states have adopted different policies for diagnostics. Assam and Meghalaya outsource diagnostic services, while Odisha outsources only few tests and is working on strengthening in-house capacity,” Ameel said.
Sanjay Pai, a pathologist, said there is 90-95 per cent success in diagnosis through telepathology or teleradiology. “Public-private partnership can work only if strict monitoring is done. PPP makes sense in cases where there is corporate social responsibility or an NGO is involved. This cuts down the scope of profiteering.”
In 2013, a World Health Organisation report found that availability of diagnostics in low income countries stands at 9 per cent as opposed to high income countries, where it is 92 per cent.
Under the teleradiology project, only X-rays are to be outsourced by the Maharashtra government. Plans to provide CT scan and MRI will be undertaken later. “As government radiologists are not available in rural areas, the government needs to rely on teleradiology so that one radiologist can work for multiple centres. I believe that instead of private vendors, radiologists in medical colleges can be used for this purpose,” said Dr Abhijeet More of Jan Arogya Abhiyaan, a network of NGOs working on health issues.