Researchers have found recent evidence that shows the growth of external, off-hours teleradiology services (EOTS) has slowed in recent years, despite a significant increase in the number of radiology practices using those services between 2003 and 2007, according to a study in the November issue of the American Journal of Roentgenology.

However, the 2003 to 2007 period saw EOTS triple from a 15 percent use rate by radiology practices and radiologists in 2003 to serving nearly half of all hospitals in the United States in 2007.

“The spread of external teleradiology services represents a large-scale change in radiology whose speed has rarely been equaled,” wrote the authors.

Non–individually identified data from the American College of Radiology’s (ACR) 2007 Survey of Member Radiologists and its 2003 Survey of Radiologists was analyzed by researchers at the department of diagnostic radiology at Yale University in New Haven, Conn.; the department of radiology and radiological science at Johns Hopkins University in Baltimore; and the Reston, Va.-based ACR.

Overall, 44 percent of all radiology practices in the U.S. reported using EOTS in 2007. These practices included 45 percent of all U.S. radiologists. Out-of-practice teleradiology services had been used by 15 percent of radiology groups in 2003, according to the researchers.

“Results showed large increases in use in 2007 compared with 2003 in almost all geographic regions, location types, practice types and practice sizes,” the authors wrote.

Heavy users of EOTS were found in the suburbs of smaller metropolitan areas, which reported a 90 percent use rate of the services in 2007. In contrast, academic-based practices reported a 15 percent utilization rate the same year. Radiology-only practices reported a 59 percent utilization of EOTS, while multispecialty practices saw only a 35 percent use of the services.

The data also demonstrated that the larger a practice, the less was its need for EOTS. Radiology practices with 10 or fewer physicians utilized EOTS at a higher rate than practices with 30 or more radiologists.

“None of the responding practices that functioned only in nonhospital sites used EOTS, compared with 61 percent of those that functioned only at hospitals and 76 percent of those that functioned at both hospital and nonhospital sites,” the authors noted.

However, in spite of predictions that the market for EOTS will continue to expand, researchers commented on recent evidence that may suggest otherwise.

“Data on the number of examinations performed taken from recent quarterly reports of the largest firm in the industry, Nighthawk Radiology Services [Scottsdale, Ariz.], suggests slower growth,” said Rebecca S. Lewis, lead author of the study.

In addition, a survey of a convenience sample of radiology practice leaders taken in the autumn of 2008, found extremely few were using teleradiology firms for daytime reads or subspeciality interpretations, although providing these services is a prominent expansion strategy of the industry. Also, a considerable number of practices that had been using teleradiology services EOTSs were no longer doing so.

“Recent reports on the radiologist job market indicate that there has been a softening of the market and that there is now a small surplus of radiologists,” the authors wrote. “The likely effect of this employment situation on the growth of external teleradiology services is ambiguous. On the one hand, it should make more radiologists available to teleradiology firms as employees, even if some of the jobs at these firms turn out to be relatively unattractive. On the other hand, it should make regular radiology practices more able to hire enough staff to cover call without strain, thus undercutting the main rationale for using EOTS.”