How Medical Image Sharing Can Lead to Privacy Issues

How can medical image sharing lead to privacy issues? TeleRay Chief Technology Officer Cody Neville highlights different delivery methods for medical images and explains how TeleRay’s methodology allows hospitals and doctors to know they are sending images to the correct patient.

Electronic Health Record Integration

How does TeleRay integrate with electronic health records, and what information is transferred? TeleRay CEO Tim Kelley explains the platform’s functionality and benefits.

DICOM, Interoperability, and the Patient Experience

In the digital age of healthcare, accessibility is critical. On the patient side, access to their health records, vital information, and providers drives more engagement. On the provider side, access to patient data in aggregate sets the stage for delivering a higher standard of care. These two sides of accessibility create a better patient experience — and they’re both made possible thanks to interoperability.

Interoperability is more than a buzzword in healthcare — it’s a crucial concept that needs constant attention and improvement as telehealth and digital healthcare systems evolve. Unfortunately, interoperability challenges persist in the current healthcare environment, prompting technology innovators to pursue standardizations, like DICOM.

Standardization as a means of data mobilization

Standardization levels the playing field for how healthcare data is created, formatted, stored, shared, and used. And it’s this standardization that directly enables interoperability. Interoperability, as defined by HIMSS, is the “ability of different information systems, devices and applications (systems) to access, exchange, integrate and cooperatively use data in a coordinated manner, within and across organizational, regional and national boundaries, to provide timely and seamless portability of information and optimize the health of individuals and populations globally.”

Take diagnostic imaging data, for example. A CAT scan generated on-site needs to yield the same level of insight when viewed off-site by a specialist, or even years later, when compared side by side to a current scan. That scan needs to preserve data no matter how many times it’s accessed, where it’s stored, or what applications is used to access it.

Standardizing medical data practices enables mobility and accessibility without loss of integrity. It’s why standards like DICOM exist for medical imaging data, HL7 for test results reporting, or SNOMED CT for standardizing medical terminology around the world. The goal is ubiquitous understanding, and it starts by ensuring everyone is using the same tools, following the same methods, and communicating with the same words.

Standardization is important and it has certainly helped, but it is not the sole solution needed for healthcare imagery. Interoperability is the next critical step in the process to ensure the images are safely and securely stored for easy and reliable access.

The growing importance of interoperability

Healthcare around the world is undergoing a booming technological evolution. The result is an increasing number of digital innovations, producing exponential amounts of data. Not only is this data important and insightful; it’s also deeply interconnected and critical to the delivery of patient care.

Leading the charge in generating critical data is medical imaging. As imaging technologies have evolved to include point-of-care ultrasound (POCUS) and similar frontline diagnostic tools, providers have become increasingly reliant on imaging throughout the patient journey. Standardization of this data — primarily thanks to DICOM — has fueled the rise of medical imaging applications to meet demand.

But DICOM alone hasn’t necessarily created interoperability. Providers’ adherence to DICOM is what has allowed medical imaging to become more accessible across the spectrum of care. It’s one thing to move data from A to B, but if you can’t use it, you haven’t achieved anything. The cleanup of tags, file set readers, and pixel data value sets — aligned with DICOM standards — ensures images can be restored wherever they’re sent. This is critical in trauma, triage, and mission-critical situations where patients can’t afford to be rescanned.

A direct impact on the patient experience

Interoperability of healthcare data across systems has a tangible impact on patients, specifically as it pertains to outcomes and experience. For instance, interoperability of radiology — the de facto diagnostic tool — is critical, and something TeleRay provides on a daily basis. With TeleRay, healthcare teams can ensure:

  • Increased speed to care
  • Faster diagnosis
  • Lower costs
  • Less frustration
  • More patient throughput
  • Better outcomes

The key is ensuring radiology images are not only kept to a high standard at the point of care, but that they can be restorable to view in future healthcare events. Without this ability, patients may succumb to unnecessary rescans, slow speed to care, or, in the event of a trauma or emergency, potential fatality.

Diagnostic imaging as a frontline treatment tool, coupled with DICOM standards to ensure interoperability, marks a new paradigm for healthcare and the potential of digitized data. It allows providers to do their jobs quicker, better, and more confidently, which leads to trust, optimism, and engagement from patients. In a world of value-based care, it’s an all-important relationship — one that’s actionable at every level.

Standardization sets the standard for experience

Interoperability in healthcare is a foundational concept — one that will continue to define the patient experience as digitization becomes more prevalent across the spectrum of care. The ability to share patient data among systems, with no loss of quality or integrity, creates a level of continuity that directly benefits patients and providers alike. It’s all built atop standardizations like DICOM to create uniformity resulting in accessibility.

Learn more about the importance of interoperability at teleray.com.

Benefits of TeleRay’s RMC

What are the benefits of TeleRay’s Remote Modality Controller (RMC)?

TeleRay Chief Technology Officer Cody Neville highlights some of the key advantages of the new Remote Modality Controller, the latest innovation in distance healthcare.

Building the Most Secure Data Transmission System

Healthcare data is anything but static. From the moment it’s generated — at the point of an ultrasound scan, for example — health data is instantly injected into an ecosystem where mobility and accessibility are crucial. Personal Health Information (PHI) is endlessly valuable to patients, physicians, specialists, and even emerging artificial intelligence (AI) and machine learning (ML) technologies designed to help automate critical healthcare functions.

Data transmissibility and interoperability are gaining steam in healthcare, but they can’t come at the expense of data security. Getting data to and from various systems is critical, but not as much as getting it there securely.

Data security in the age of digital healthcare

In an era of regular data breaches, the concept of data security has never been more important for healthcare providers. The sheer volume of healthcare data is increasing rapidly. Providers must safeguard patient information, a challenging undertaking — especially during data transmission, which is critical for ensuring this healthcare data is available where and when it’s needed.

It bears repeating: Data transmission cannot come at the expense of data security. Healthcare providers must look beyond the point of capture and adopt data standards that safeguard PHI at every phase in the chain of custody, including storage and transit. As the healthcare industry embraces interoperability and data sharing, providers must adopt frameworks emphasizing protection.

Cognizant of the data security challenges providers face, TeleRay offers a proactive approach to data security. Specifically, we implement frameworks prioritizing data security across the spectrum of data handling: from capture to transmission to storage. Our telehealth platform is fully DICOM-integrated and HIPAA-compliant, ensuring patient data is secure during transmission. Plus, TeleRay has no stored PHI, which eliminates the risk of sensitive data breaches.

Transport layer security (TLS): protecting health data in transit

Healthcare data is private and valuable, making it a prime target for cybercriminals and bad actors. Protecting PHI at every level — including during data transmission — is critical to maintaining privacy and security. Healthcare providers must implement data standards that not only optimize accessibility and mobility, but also safeguard data against breaches.

Transport layer security is a widely adopted security protocol providing privacy and data security for communications over the internet. TLS encrypts web applications’ communication and servers, including email, messaging, and voice-over IP (VoIP), to protect against data breaches and other cyberattacks. Specifically, TLS encryption protects data by:

  • Validating the authenticity of parties exchanging information
  • Verifying the data has not been tampered with or forged
  • Hiding the data from third parties

TLS doesn’t just mobilize data; it safeguards providers against liability. With the increasing pervasiveness of over-the-air interception, TLS makes certain data gets from one system to another securely — be it physician to physician, doctor to patient, or site to site.

TeleRay’s approach to secure data transmission

TeleRay takes a proactive approach to data security in healthcare by implementing frameworks for protection. To ensure the privacy and security of patients’ personal health information in transit, TeleRay utilizes a variety of state-of-the-art data security measures:

  1. TeleRay uses random AES keys for data packet transmission security. Clients generate a key at the beginning of the media connection, ensuring the encryption keys used to protect PHI are unique and not vulnerable to being guessed or intercepted by unauthorized parties.
  2. TeleRay employs an AES unique cipher with 256-bit keys to encrypt audio and video, making data significantly less susceptible to breaches or interception.
  3. HMAC-SHA1 is used to verify data integrity, confirming the data has not been tampered with during transmission.
  4. Transport layer security (TLS) encrypts both voice and video data, providing an additional layer of protection against interception and data breaches. The core protocols used for media traffic encryption are SRTP and DTLS-SRTP for key negotiation, both of which are defined by the Internet Engineering Task Force (IETF).

Overall, our approach to secure data transmission protects PHI at every stage of the data transmission process. By implementing strong encryption and key management protocols, TeleRay helps healthcare organizations maximize the privacy and security of their patients’ sensitive health information.

Protect healthcare data with TeleRay

There’s no substitute for security when it comes to healthcare data, which means there can be no compromising in the systems used to safeguard it. From the point of capture, to storage and retrieval, to transmission and accessibility of any kind, TeleRay’s carefully engineered system is not only secure and efficient, but also seamless and easy to use. It’s what happens when you marry a security-first approach with a commitment to patient and provider satisfaction.

To eliminate fear in the decision process, TeleRay offers an industry-first $2,000,000 breach policy to indemnify their customers against any breach actions. Feel safe, be safe, with TeleRay.

Learn more about TeleRay’s approach to data security at teleray.com.

Common Misconceptions About Teleradiology

What are the misconceptions about teleradiology? TeleRay CEO Tim Kelley dispels some of the most common teleradiology myths people mistakenly believe.

Proper Reimbursement Coding is Critical for Telehealth Image Sharing Success

Medical coding and billing is a complex, ever-evolving landscape. From contextualizing the nature of services rendered and coding them properly to billing against health insurance and beyond — there’s plenty of room for error throughout the process. Often, it’s the patient who’s left with a headache due to incorrect coding, but providers also stand to lose revenue with each billing mistake. This couldn’t be more evident now, during the rise of telehealth services.

TeleRay is acutely aware of the crucial importance of proper reimbursement coding for telehealth services. It’s why we provide consultancy regarding reimbursement rules, codes, and billing: to help providers streamline their practice management.

The many complexities of medical coding and billing

In theory, medical coding (and, by association, billing) is a simple concept: Correlate the service provided with its representative code so insurance companies can handle claims accordingly. In practice, unfortunately, there can be a wide gap in services administered vs. appropriate coding.

For example, CPT Codes 76801 and 76817 both represent an ultrasound given to a pregnant woman. The difference? The former is for a transabdominal approach, while the latter signals a transvaginal approach. This singular detail distinguishes the procedures and determines how they’re billed and reimbursed by an insurance provider. That same patient may need those images sent to another provider, which may be reimbursable under store-and-forward reimbursement codes.

To complicate matters further, improper medical coding for reimbursement can quickly snowball into a slew of problems, ranging from denied claims to Medicare/Medicaid audits. An incorrectly coded claim tends to result in lost revenue for providers and a negative experience for patients.

Telehealth and image sharing reimbursement as an emerging consideration

The rise of telehealth services has led to increased accessibility in healthcare. Today’s patients can take full advantage of remote technologies to get the care they need, such as remote diagnostics through TeleRay Live or real-time access to medical imaging via TeleRay Reports. Unfortunately, telehealth has complicated the already cumbersome process of trying to code for proper reimbursement.

Let’s say a patient has an appointment with their gastroenterologist to review diagnostic ultrasound scans. How would a provider code this? CPT Modifier 95 indicates synchronous telemedicine services, but a coding professional still needs to determine which code (91200-91299) to modify. There are CMS codes specifically designated for this type of telehealth service as well, including CMS G2010 and G2250.

And did we mention telehealth coding and reimbursement rules are payor and state dependent? It can all get vastly confusing.

Here, again, classifying the wrong code can perpetuate a variety of problems. While telehealth can potentially be an efficient revenue stream for providers — not to mention a convenience for patients — improper coding can erase these positives and replace them with frustrating experiences and outcomes.

TeleRay simplifies provider reimbursement coding

Although there are numerous intricacies associated with the appropriate coding and billing of telehealth services, perhaps the most difficult consideration is the continually changing nature of telemedicine in the eyes of the government and health insurance providers.

It was only recently (November 2022) that the Centers for Medicare and Medicaid Services (CMS) released its final 2023 Medicare Physician Fee Schedule (PFS) and guidance on telehealth reimbursement. And while the guidance clarified several previously uncertain policies, it also added nuanced complexities to how providers can bill for telehealth services.

Telehealth and image sharing continue to effect seismic shifts for providers trying to offer these services to patients and bill for them efficiently and accurately. It’s why many providers are partnering with stewards like TeleRay for consultancy on reimbursement rules, codes, and billing. Having a partner abreast of current and upcoming changes to telehealth-related CPT and CMS coding, as well as reimbursement policy changes, can give providers an edge in maintaining a healthy telehealth revenue stream.

An opportunity for both patient and provider

Coded correctly, diagnostic telehealth and image sharing services offer an opportunity to expand patient access to critical imaging modalities — while also opening a new revenue stream for providers. But an incorrect approach to reimbursement can just as easily create complications. That’s why it pays to have a partner who understands not only the proper coding approach, but also the evolving telehealth landscape.

Learn more about proper reimbursement coding at teleray.com.

What Impact Does Digital Image Exchange Have on Patient Continuity and Care Coordination?

Patient care, especially for long-term or chronic condition, often involves a team of healthcare professionals, including primary care physicians, specialists, consultants, nursing staff, pharmacists, lab personnel, and others. Together, this team provides continuity of care for the patient. But to deliver high-quality care, the team must rely on secure, reliable, and HIPAA-compliant data and medical image sharing to ensure all caregivers understand the patient’s history and current needs.

What is patient continuity and coordination of care?

According to the American Academy of Family Physicians, “Continuity of care is concerned with quality of care over time. It is the process by which the patient and [their] physician-led care team are cooperatively involved in ongoing health care management toward the shared goal of high quality, cost-effective medical care.”

Not only does continuity of care support greater visibility and transparency throughout a patient’s healthcare journey; it also supports early detection, more accurate diagnosis, and improved outcomes. Additionally, continuity of care has been linked to better patient-provider relationships, promoting greater trust and a feeling of safety.

The Agency for Healthcare Research and Quality (AHRQ) defines care coordination as “deliberately organizing patient care activities and sharing information among all of the participants concerned with a patient’s care to achieve safer and more effective care.” Coordination of care involves a team of healthcare workers who provide patient care in coordination with others. Good communication among physicians, nursing staff, lab workers, pharmacy staff, and the patient is vital for providing safe and effective care.

What’s the value of medical image sharing for patient continuity and coordination of care?

Continuity and coordination of care requires collaboration among all providers and related staff involved in a patient’s continuum of care. That collaboration means sharing electronic health records (EHR) and medical images, as doing so allows doctors to understand what treatment strategies have already been used and how the patient has responded. Also, when doctors refer patients to a specialist, or an insurer requires a different doctor, sharing medical information and images is essential. Unfortunately, images and reports are all-too-often separated in the transfer process. In fact, 80% of the time EMR data is transferred, it lacks supporting imagery, and when images are transferred, 80% of the time they are not accompanied by the report.

Traditional file sharing over email, database downloads, or CDs is simple and straightforward. Even graphic or image files such as JPEGs can be shared using traditional file transfers. Sharing medical images, conversely, is not that simple. Transmission and management of medical images must adhere to the standards and protocols of Digital Imaging and Communications in Medicine (DICOM). The internationally recognized DICOM format specifies that images conform to high standards, which allow for accurate interpretation and diagnostics. As a result, radiology departments must use special software to view these images. Unfortunately, sharing these images also presents challenges pertaining to privacy, security, and image integrity. The large sizes of these files also means there are limited methods for storing and sharing.

How does TeleRay’s image-sharing platform support patient continuity of care?

DICOM images have become an essential tool not only for diagnosis and treatment by a healthcare provider, but also for continuity and coordination of care among providers. Of course, all of this requires the ability to store, view, and share medical images. For example, TeleRay’s platform enables providers to attach images to Epic’s patient portal, MyChart. Providers also can add reports into a patient’s electronic medical record, providing more comprehensive patient information. Ensuring DICOM images can be viewed and shared securely and privately — and the process complies with HIPAA regulations — has its own challenges.

DICOM has mechanisms to establish confidentiality for an image’s header data, but not for the pixel data. And although DICOM does provide authenticity and integrity for the pixel data, it doesn’t offer the same guarantee for the header data. Additionally, security and sharing mechanisms must be compatible with a healthcare provider’s IT infrastructure. That’s why providers and radiology departments are turning to the TeleRay platform for simple, secure, and compliant image exchange that supports patient continuity and coordination of care — every time.

If your organization needs a comprehensive solution to ensure safe, secure, and HIPAA-compliant storing and sharing of medical information and images, TeleRay can help. Contact us at 844-4-TELERAY (483-5372) or visit TeleRay.com.

TeleRay RMC Advances Remote Control Modalities

Healthcare is entering a period of seismic change. Worker shortages, an aging population, and a post-pandemic era of healthcare concerns are all shaping what healthcare will become over the next several years. But for every struggle, there’s an innovation waiting to address the challenge, powered by companies committed to staying on the leading edge.

Telehealth, remote patient monitoring, and distance healthcare have all emerged in the wake of the pandemic to allow more patients access to the care they need, regardless of location. Now, TeleRay is excited to announce its contribution to this growing landscape of innovative practices, devices, and modalities. TeleRay RMC is a remote-control solution for enabling diagnostic imaging from anywhere, at any time, for any need.

Take control of equipment (and workflows)

The TeleRay Remote Modality Controller (RMC) is the latest innovation in distance healthcare. Using the USB and standard video ports of CT, MRI, ultrasound, or any other imaging modality, the TeleRay RMC enables complete keyboard and mouse control from remote locations with screen visualization.

Not only can doctors, X-ray technicians, and other healthcare professionals take diagnostic images from anywhere, but TeleRay’s RMC also boasts many other use cases — especially when it comes to system maintenance.

TeleRay’s RMC enables remote troubleshooting, updating, training, general checkups, and more. With it, there’s no need for medical staff to wait hours (or days) for a repair technician to arrive on-site — or spend upwards of $3,000 per visit. And given the requirement for multiple visits in many troubleshooting and repair situations, that cost can certainly compound quickly.

Resolving complex cases through defined protocols

It’s becoming more challenging to find advanced technologists with an expert-level grasp of a wide range of appropriate remote radiology protocols. Their knowledge of operationally complex technology is essential for a variety of healthcare facilities, but finding the right talent and keeping them on-site full time can be both difficult and expensive.

TeleRay’s RMC is poised to help healthcare teams handle complex use cases along with more routine protocols still requiring the advanced know-how possessed only by an experienced technologist.

For example, a cardiovascular MRI is a powerful tool, but only when used by a knowledgeable operator. It relies on operationally complex technology, and the technologist needs a thorough understanding of not just the equipment itself, but also the relevant anatomy of cardiac and vascular pathophysiology.

TeleRay enables remote control of image modalities, allowing technologists to deliver exceptional patient care from any location. In this way, TeleRay is closing the skills gap in this sector of the healthcare industry, with the ultimate goal of improving overall patient care.

Simple, versatile, and effective for remote operation

The TeleRay RMC system is an all-in-one, mobile, and easy-to-use solution for a multitude of issues currently facing the medical imaging sector. Not only does this innovative technology enable remote training and service — saving healthcare teams time and money — there are also many other valuable use cases for TeleRay’s RMC system, including:

  • Patient data accessibility. TeleRay’s fully digital solution provides more accessibility to patient data, for healthcare providers and patients alike. Access to patient data is almost instant before and after scans. It’s also quick and easy to share electronic health records (EHR) information across all touchpoints of a patient’s care.
  • A better patient experience. Digital radiology technology creates an overall better patient experience for a variety of reasons. Not only does it lower costs for healthcare teams — which can be passed on to the patient — it also improves treatment outcomes with the support of artificial intelligence and analytics that are integral to digital diagnostic technology.
  • Patient confidentiality. Digitization enables EHR, a much safer alternative to paper-based systems. TeleRay makes it easier and safer for healthcare providers to send and retrieve patient information, including digital images. With highly advanced encryption and security capabilities, electronic records will be protected.

The next evolution of telehealth services

As the healthcare industry turns to remote patient monitoring and other remote-enabling administration tools, solutions like TeleRay RMC will lead the way in promoting access, affordability, and a higher standard of patient care. From cardiology to oncology and everything in between, imaging is a cornerstone of care. TeleRay is committed to bringing quality care to patients where they are, eliminating barriers wherever they exist.

Learn more about other groundbreaking developments in remote healthcare at teleray.com.

Radiology Image Trends to Watch in 2023

MedTech is evolving at a rapid pace as the healthcare industry undergoes broad digitization. Among the new technologies supporting a higher standard of patient care is medical imaging. Radiology is going through a period of innovation as both hardware and software evolve — and new applications emerge.

As we look ahead to 2023, it’s important to explore these emerging technologies and the trends that follow them. Today’s advances impact tomorrow’s practices, and medical imaging stands at the forefront of how digital technology will quickly transform diagnosis, treatment, and total patient care.

Here are some of the radiology and imaging trends to watch in 2023, along with the ways they’ll impact the changing digital healthcare landscape.

Cloud-based storage/exchange

Today, much of healthcare happens in the cloud. Data generated at every point of patient care must go somewhere, and it’s being aggregated into digital charts accessible to patients and providers alike. This virtual standard for data is fueling an even greater level of integration at the point of use for MedTech.

In 2023, expect to see advances in digital synergy between imaging equipment and the cloud systems that support patient data. From scans that directly populate into the cloud to the ability of providers to share images with other clinicians through secure virtual repositories, cloud-based storage and image exchange will set the tone for radiology advancements in the coming year. This is likely to lead to even bigger implications, such as lower cost of care based on the mobility of image data.

Radiology in telehealth

Telehealth is rapidly changing the landscape for different segments of healthcare, including radiology. Today, doctors and patients don’t need to be in the same room to engage in a consult — and neither does the radiology equipment. This is especially useful in rural areas, where bringing together equipment, physicians, and patients in the same place, at the same time, can be especially challenging.

On the backbone of cloud systems, patients can visit a clinic for scans and imaging and then converse later with their provider about the results. Telehealth allows patients and providers to connect over the same images and discuss conditions and treatments with the full breadth of context they’d enjoy at a fully equipped healthcare facility. Providers should expect a boom in radiological telehealth demands in 2023.

AI and ML in medical imaging

Artificial intelligence (AI) and machine learning (ML) are transforming the way providers understand and apply patient data — right down to assisting with diagnosis. AI and ML are being used not only to qualify medical images but also to clarify tolerances that lead to more accurate diagnoses. Imagine a program capable of reading an MRI or CT scan, processing the image to improve clarity, and delivering a possible diagnosis based on evident factors within certain known tolerances, as determined against similar scans.

AI and ML are swiftly moving into the radiology and imaging field, and they’re making it easier for physicians to diagnose with accuracy, confidence, and speed — all factors that improve the standard for patient care and translate to better outcomes.

POCUS and field imaging

Traditionally, radiology’s biggest constraint has been the size and complexity of its equipment: MRI machines that take up an entire room or delicate piezoelectric ultrasound components. Point-of-care ultrasound (POCUS) equipment represents a step toward smaller, simpler, field-ready imaging equipment. Today’s POCUS devices can sync to a smartphone and transmit imaging over a network with the same clarity as larger static devices.

POCUS serves patients in the same way telehealth enables equitable access to medical images for rural patients and anyone displaced from equipment or medical professionals. As the name implies, it brings imaging to the patient. In 2023, we can expect a rise in POCUS in support of telehealth.

The constant evolution of MedTech

As these trends gain momentum and continue to shape the landscape of medical imaging, they’re accelerating advancements in new healthcare practices that lead to better patient outcomes. From AI-driven precision imaging to the synergies made possible by remote patient monitoring, radiology isn’t just an important tool in modern medicine — it’s laying the groundwork for the next generation of healthcare.

For more on emerging trends in diagnostic imaging, visit teleray.com.