The Teleradiology UOSD was activated in 2018 as the Telemedicine UOSD and has assumed its current name since 2019.
It carries out Radiological Diagnostics through the Home Radiology service (traditional X-ray and ultrasound) and has as its Mission the Clinical Management of the RIS PACS information systems, the Coordination of the Spoke Hub Radiological Teleconsultation, the integration of the Bioimaging Information Systems, the activation of the Health Dossier and the ESF.
Coordinates teleworking activities, manages the RIS PACS Tele-radiology Operating Room for Teleconsultation, optimises the clinical-diagnostic and care activity of users in relation to the RIS PACS platform and related applications, with the development of operating procedures dedicated to the control and monitoring of flows to guarantee diagnostic and care continuity.
It manages the Company Digital Signature of users and the RIS PACS Company Radiological Archive.
Coordinates the activity of System Administrators.
Interacts with NHS Bodies, Institutes and Companies for the implementation of Telemedicine/Teleradiology Projects and Programs.
In its various applications, Teleradiology is an innovative element in the programming of Operating Units and delivery points for Diagnostic Imaging services to optimize the response to the needs of the territory.
The fields of application are as follows:
- Teledistribution: It is the sending or making available of the diagnostic imaging survey to the patient or doctor, authorized by the patient, including the iconography and the report, which must be made available simultaneously forming a single documentary entity.
- Teleconsultation: With a request from a radiologist to a radiologist and from a doctor of another discipline to a radiologist, as advice on an examination already performed (and reported by another radiologist) or for advice during the examination between 2 radiologists, one present at the examination site and one in a decentralized location.
- Remote management: Remote management means the management of a radiological diagnostic examination by a radiologist, distant from the place of execution of the examination, who uses the collaboration of the requesting doctor and the TSRM, present at the place of execution of the examination with whom he communicates, in real time, by telephone and/or telematics. The remote management is completed with the remote diagnosis formalized by the report with a validated digital signature of the radiologist responsible for the remote management.
Since the main interest towards users is the Home Radiology service, only this activity will be referred to.
Services / Activities provided
Home Radiology is a service that, with the help of dedicated equipment, allows diagnostic investigations to be carried out directly at the patient’s home.
The objective is to provide a Home Radiology Service totally focused on the needs of the patient, especially in favour of the elderly, the disabled or people whose health conditions do not allow transport to a hospital facility, offering the possibility of carrying out radiological and ultrasound examinations within the home walls, avoiding the multiple inconveniences of patients and meeting the needs of family members often left alone to face the many logistical difficulties.
However, it is useful to make an important clarification regarding the public service of home radiology: this service is to be considered complementary to a traditional radiology service and not a substitute, this is because many tests that can be performed in a radiology department cannot be performed at the patient’s home due to technological limitations.
- Rx on any skeletal segment
- Chest X-ray
- Abdominal Ultrasound
- Vascular echodoppler
- Musculoskeletal ultrasound
- Thyroid ultrasound
The only constraint to offer the home radiology service is given by the characteristics of the patient; home radiology is not a service for everyone. Providing this service to people who have no problem going to the hospital is equivalent to a waste of resources and not indifferent time, for this reason the service was intended exclusively for geriatric, oncological, psychiatric patients, or in any case for patients in conditions for which the transfer to the hospital is objectively investigative. In fact, the concept of home diagnostic service is nothing more than an extension of the radiological services that, on a daily basis, are carried out in the hospital wards at the bedside of the patient who is considered to be intransportable to the Radiology department.
Who is it aimed at?
The service is particularly advantageous in the presence of patients for whom mobilisation may be risky and/or difficult (bedridden, immunosuppressed, psychophysical, geriatric, traumatised, newborn, oncological patients, etc.).
Patients who can still benefit from a public home radiology service are:
- People with lung diseases;
- People with heart disease;
- People suffering from oncological diseases;
- People suffering from neurological diseases;
- People with osteoarticular diseases;
- People undergoing orthopaedic interventions for the placement of prostheses;
- People with movement difficulties or non-ambulatory;
- Disabled people.
The services under the agreement for radiological examinations at home with the National Health Service are provided only upon presentation of commitment of the requesting doctor, to be submitted directly to the Recup: the dematerialized request must include the diagnostic question and the specification of the examination to be performed at home or non-transportable patient for Radiological Control Televisit (CUR Code e01_46).
At the recover counters, the day of execution of the exam will be established, with an indicative time and delivery to the user of the relative forms to start the domiciliary procedure:
- The information model and consent for the execution of the examination, which must be signed by the patient or by their guardian, with self-declaration of Legislative Decree 19 of 25/3/2020;
- The preparation scheme for the ultrasound examination;
- The form with the booking date.
The forms must be sent (by family members or the applicant) by email or fax to the organisational Secretariat of the domiciliary, to the addresses listed at the bottom of the booking form, in order to:
- check if the documentation is complete and if the consent has been signed
- contact family members for accurate home address information
- inform family members or the person concerned about the presumed time of the examination; in addition, the presence and assistance of family members or staff may be necessary for the execution of the examination.
These forms, including the printing of the prescription, must then be delivered in original to the staff who will carry out the examination.
The compilation of the information/informed consent form and its sending to the Secretariat is a mandatory condition for the execution of the examination.
For a better diagnostic result in ultrasound examinations of the abdomen (upper, lower and urinary system), the instructions in the annex will be delivered to the patient.
The Service Secretariat will then contact the interested parties to confirm the date and time of the appointment.
The times shown in the appointment time slots are indicative and it will be the responsibility of the Service Secretariat to communicate the actual time and ascertain if you opt for the online collection (on the Regional Portal) of the exam performed.
The annexes contain the informed consent information form and the preparation scheme for ultrasound examinations.
Collection of Reports
The collection of diagnostic reports varies according to the type of examination and in any case a maximum period of two working days following the examination is guaranteed; at the time of booking, the Patient is informed of the time of collection of the report.
The collection of the exams will take place, if the applicants have opted for the collection on site (and not from the regional portal), at the front offices of the Radiology services closest to the applicants.
The reports remain available at the Service Secretariat up to 30 days from the date scheduled for withdrawal; failure to withdraw the report relating to services provided under the agreement entails the necessary communication to the competent ASL which will charge the client the full cost of the service.
Hours and Days of Receipt
Given the territory of the ASL of Frosinone, the subdivision by municipal areas was prepared in the organization of these appointments, already in the booking phase at the RECUP.
The Secretariat of the Home Diagnostics Service, located on the Ground Floor, body C of the Sora O.P., next to the RECUP branches, is empowered to provide users with all the information and any clarifications.
Observe the following opening hours: from 09.00 to 12.00, on Mondays, Wednesdays and Fridays.
Example: Chest radiogram
What is it?
It is an investigation that uses ionizing radiation to study the thoracic structures: the rib cage with the ribs, the lung and pleura, the large vessels of the mediastinum, the heart and the small circle. The chest radiogram was one of the first applications of X-rays and, to date, is one of the fundamental investigations and most frequently used in clinical practice. No other examination, in fact, allows the chest to be explored so quickly and in any clinical situation, even in an emergency, in the face of a very modest cost and biological risk from irradiation.
Why do it?
The indications on examination are multiple: chest pain, respiratory difficulty, the suspicion of a cardiovascular problem, the presence of diseases in other organs or districts but which can also affect the chest, the prospect of surgery, the control of critical patients…
There are so many indications on the chest radiogram that one of the problems that has recently emerged is precisely that of avoiding its indiscriminate use when the diagnostic and therapeutic benefit is modest or even absent.
When is it not done?
Like all instrumental investigations, the chest radiogram should not be carried out in the absence of a precise diagnostic question: we remember in particular the need to limit routine examinations still required today in categories of patients without specific risks.
Before the exam
Before the examination, no preparation of the patient is necessary. However, any radio-opaque objects (necklaces, chains) must be removed from the chest and the examining operator must be informed of the presence of skin formations (snows, warts) that can simulate the existence of pulmonary opacity. The patient should briefly inform the examiner of the problem under investigation and mention any previous chest diseases, including traumatic events, or if he/she suffers from cardiovascular problems. It is often very useful – and saves unnecessary radiation – to compare with any previous radiograms, which must therefore be recovered by the patient and delivered at the time of the examination.
How does it work?
The examination is performed, whenever possible, on an erect patient. In the frontal projection radiogram, the front of the chest is rested on the cassette, the chin slightly raised, the arms resting on the hips with elbow cones moved forward to avoid overlapping of the shoulder blades. The patient is invited to take a deep breath and maintain the apnea for a few moments while the x-ray is performed. The lateral projection, when necessary, is carried out with the side resting on the box and the arms raised. As needed, radiograms can also be obtained in different obliquities, possibly under the control of radioscopy.
After the exam
There is no precaution or therapy to be followed after the examination; the radiogram is examined by the radiologist, who assesses whether the investigation answers the clinical question or whether it is appropriate to carry out a radiological (e.g. CT scan) or other diagnostic examination (e.g. specialist pulmonological examinations).
What is it?
Echotomography or ultrasound is a method of investigation that produces images of the human body using ultrasound (very high frequency sounds), thanks to their reflectivity by the different body tissues: the principles underlying the eame are the same as radar and sonar. The most sophisticated equipment makes it possible to analyse reflected ultrasound (echoes) in greater detail, also obtaining information on the flow of blood in the scanned organs (echo-Doppler, color-Doppler, Power-Doppler).
Under the conditions of the examination, the crossing of the tissues by ultrasound does not produce appreciable biological consequences: for this reason, no harmful effects attributable to ultrasound have been documented so far, which can therefore be considered a risk-free examination and without any contraindication.
Why do it?
Ecotomography can be usefully used in the study of all parenchymal organs and some hollow organs (stomach and bladder) of which it is able to specify the structural alterations resulting from numerous diseases.
In particular, ultrasound can highlight nodules of different nature, as long as they reach appreciable dimensions (5-10 mm). Ultrasound is not indicated in the study of organs surrounded by bone or air (which ultrasound cannot cross) and must be preceded by other investigations under certain conditions (for example, in selected cases, breast ultrasound must be performed to complement mammography in women over 35-40 years of age).
Before the exam
For the study of the abdominal organs (in particular liver and gallbladder) it is good practice to follow, in the 3 days before the examination, a slag-free diet (do not take vegetables and fruits, cheeses and carbonated beverages) and observe absolute fasting for at least 5 hours before the examination (water and medicines can be taken freely). On the other hand, for the study of the pelvic organs (bladder, uterus and ovaries, prostate), it is necessary to have a full bladder (having finished drinking 1 litre of water about 1 hour before the examination). In particular conditions (study of abdominal and pelvic organs in patients suffering from constipation) it is advisable to carry out a cleaning enema. No preparation is required for all other exams.
How does it work?
The examination is neither painful nor annoying: the radiologist spreads a conductive gel on the skin surface above the section to be explored and moves the probe that emits/receives ultrasound on it; the examination lasts 10-20 minutes, during which the patient must avoid movements and must, at certain times and at the request of the examiner, hold his breath.
After the exam
Once the examination is finished, the patient must not follow special regimens or prescriptions and can immediately resume his normal activity. The radiologist may recommend repeating the examination after carrying out a more thorough preparation, if the one carried out was not sufficient.