Cost-effective and efficient teleradiology services geared to meet patient demand post-COVID 19 and beyond

2020 09 11 18 52 4636 2020 09 10 16 23 4829 2020 09 14 Minolta Exa Gateway Image

As countries and economies shut down to contain COVID-19, the demand for nonurgent radiology services plummeted. Many imaging facilities throughout the U.S. were closed during the first wave of COVID-19 in spring 2020, with exam volumes dropping between 40% and 90% in radiology practices.1

In one healthcare system, study volume losses ranged from 39% to 60% across three hospitals, with outpatient imaging volume losses higher at 55% to 70%.2 The financial impact on this healthcare system was just as great, with a net revenue loss of nearly $5 million.2

Today, radiology practices are reopening, but based on conditions in each state, the level of elective procedures being performed varies. Additionally, there are fears of a second wave of SARS-CoV-2 infection, further complicating business planning and creating uncertainty.

Restarting radiology

Restarting radiology services is crucial for practices and imaging centers to avoid further financial losses as well as for patients who have delayed important screening or diagnostic tests. As volumes pick up, a surge is expected that may exceed the capacity of staff radiologists in many institutions, necessitating many hospitals and radiology practices to require outside reading support to handle the overflow.

Either expanding or implementing teleradiology and remote reading services may become the "new normal" for many radiology groups3 to address this surge in medical imaging and beyond. The use of teleradiology can also help decrease report turnaround times and increase access to subspecialists,3 which further enhances the quality of radiology services.

To recoup lost income during the first COVID-19 wave, and potentially from a second wave, radiology practices should aggressively market their services to expand and diversify their referral base.2 This may include implementing cancer diagnostic and therapeutic services in partnership with local cancer care physicians and practices. It is anticipated that the backlog of cancer imaging studies (postponed and rescheduled) will lead to a surge that could overwhelm both imaging capacity and personnel, including radiology reading.4

While teleradiology is not a new concept, not all radiology departments and imaging centers are set up to streamline the secure sharing of patient data and images. To address the demand for efficient remote reading and teleradiology services without requiring a significant investment in new technology, Konica Minolta Healthcare has introduced Exa® Gateway.

Exa Gateway is a cost-effective platform for secure remote reading that connects hospital radiology departments and practices with teleradiologists. Radiology practices can add to or start remote reading services with a solution that streamlines and reduces the cost of connecting with teleradiologists. They can implement remote viewing capabilities and assure access to handle overflow of studies or obtain overreads and subspecialty interpretations.

Included with Exa Gateway are the technical services provided by Konica Minolta; the company implements and maintains connectivity between the parties. There is no additional strain on existing IT staff and resources. By design, Exa Gateway streamlines and reduces connection costs for the teleradiologist by providing a single connection to multiple imaging practices.

Through Exa Gateway, studies are transmitted to the appropriate teleradiologist for interpretation and final reports are then sent back to the originating site. Exa Gateway utilizes a facility's existing PACS investments and environment, minimizing upfront costs and enabling teleradiologists to use their current PACS worklist and viewer.

Konica Minolta

For the radiology practice to perform remote reading, all that's needed is a web browser utilizing existing workstations. Exa's Zero Footprint viewer is built with full diagnostic toolsets and viewing capabilities, with no downloads or plugins required. Since Exa's viewer is browser-based, studies can be viewed from any device, including tablets and smartphones.

Additionally, Exa Gateway comes with Server-Side Rendering. With all the work being done at the server and not the workstation, large imaging studies such as 3D mammography and large-volume CT studies can be opened immediately, further enhancing efficiency in remote reading.

Beyond a technology platform, Exa Gateway is a service that aligns radiology practices with teleradiologists. Konica Minolta connects the groups with one another through its vast sales and dealer channel.

As radiology practices reopen and begin to recoup from the financial losses during the first wave of the COVID-19 pandemic, Exa Gateway provides a secure, efficient and cost-effective solution for remote reading capabilities. It is also a blueprint for the future of radiology reading, in which teleradiology and remote reading will play a larger role, especially as many communities and facilities address radiologist shortages and a lack of subspecialization.


  1. Sharpe RE, et al. Special report of the RSNA COVID-19 Task Force: The short- and long-term financial impact of the COVID-19 pandemic on private radiology practices. Radiology. July 17, 2020.
  2. Mossa-Basha M, Deese J, Vincic D, Sahani DV. Coronavirus disease 2019 (COVID-19): Radiology department financial impact and planning for post-COVID recovery. J Am Coll Radiol. 2020;17(7):894-898.
  3. Bassett M. Preparing for a post-pandemic radiology practice. RSNA News. July 22, 2020. https://www.rsna.org/en/news/2020/July/Post-COVID-Practice
  4. Luker GD, Boettcher AN. Transitioning to a new normal after COVID-19: Preparing to get back on track for cancer imaging. Radiology: Imaging Cancer. April 15, 2020.
  5. Siegal DS, Wessman B, Zadorozny J, et al. Operational radiology recovery in academic radiology departments after the COVID-19 pandemic: Moving toward normalcy. J Am Coll Radiol 2020.

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