- jfcherry / Health Photos / CC BY-SA
What Stops Your Healthcare Organization from Implementing Telehealth?
Part 3: Healthcare Provider Acceptance and Patient Awareness
This is the third in our series of articles, which will provide information that attempts to break down the hurdles that limit Telehealth deployment. So far we have tackled cost considerations associated with initial start up of a Telehealth Program and reimbursement concerns as well as across state licensing and credentialing restrictions. Here we will discuss possibly the highest hurdle to Telehealth deployment, the human factor. We've said it before, but it bears repeating that there is no one size fits all solution. However, we will demonstrate via this series that the hurdles are slowly being removed and access expanded.
Here are some of the topics to be covered throughout the series:
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Initial Start-up Costs with Limited Reimbursement
-
Across State Licensing
-
Credentialing Restriction
-
Provider Acceptance
-
Patient Awareness
-
Security and Privacy
-
Managing Technology
-
Costs
-
Training
-
Connectivity and Networking
HURDLE #3: Provider Acceptance & Patient Awareness/Resistance to Change:
With a focus on outcomes driven healthcare, we know that The World Health Organization (WHO) as well as CMS and VHA believe in the promise of Telehealth.
Most of us are resistant to change, fear of the unknown especially when we lack familiarity or information required to make an informed decision. This same lack of familiarity and information can derail any Telehealth deployment plan. Even with buy-in from hospital CEOs and Nursing Home administrators and owners, without provider acceptance and patient awareness, your program can go under-utilized or even unutilized, making it impossible to realize the promised benefits of Telehealth or garner any success. Without user participation, your program joins that unused treadmill currently sitting in many homes, collecting unhung clothing. Users are the path to a self sustaining Telehealth program.
Physicians:
While many of us are eager to try technology for technolgy's sake, physicians and nurses are about providing care. If the technology is cumbersome and the connection slow, with too many additional steps in the work-flow, providers will not accept Telehealth as the mode of care for their patients. Any Telehealth program manager must hear the needs of providers and be careful to act on them in order to promote Telehealth utilization. The Telehealth encounters should closely emulate the ease of use of a traditional face-to-face encounter, while providing the efficiency and efficacy of a Telehealth consultation. Key points to highlight include the speed by which a specialist consultation could be facilitated for a patient in need and the reduced errors in reporting since reports and documentation can be completed in real time eliminating transcription or recall errors . Seamless coordination of care is the value proposition to care providers. A major component impacting use, is the appropriate training of providers and others who will interact with the technology that facilitates Telehealth. As with any new subject, quality training can ensure that providers involved in the program gain a comfort level that enables them to be in control of their sessions reducing delays associated with the use of new technology.
Patients
Patients and their families can greatly benefit from increased and enhanced access to care that can be enabled through Telehealth. However, patients who are not familiar with this concept may be uncomfortable or simply fearful of the technology and its implications in their ability to receive what they perceive as quality healthcare. Studies indicate that Telehealth Awareness and training of patients can drive comfort and satisfaction with Telehealth applications. Familiarization with the technical components, engagement of family members and emphasizing the timeliness, convenience and easy coordination of care will earn a satisfying healthcare experience for both patients and their families.
To Summarize...
While we can intuit the benefits of Telehealth, Access, Quality and Cost Savings: We need to ensure that we communicate with and train fully those who will actually use Telehealth in their daily routine, providers and their surrogates as well as patients and their families.
Awareness issues are tough to tackle, but with heightened awareness and advocacy behind Telehealth the momentum is heading in the right direction!
If your Healthcare Organization can benefit from more information, contact Excalibur Healthcare and we can work with you to set up a telehealth program or a small pilot project.
Equipment financing and leasing now available!
Photo credit: mnlamberson / Foter.com / CC BY-NC-SA
Here are my top 10 tweets from this past week... Great for Retweeting!
If you missed these, be sure to follow us on Twitter to keep up with the latest in healthcare topics including telemedicine, telehealth and medical imaging news:
- Stanford study says MRI scans can predict outcome of math tutoring - San Jose Mercury News http://hub.am/15eUm2l #MRI #radiology
- Role of cerebral ultrasound and magnetic resonance imaging in newborns with congenital cytomegalovirus infection http://hub.am/10HUnsN
- Cost considerations associated with initial start up of a Telehealth Program http://hub.am/12106Iq #telehealth
- Tissue Damage from Metal-On-Metal Hip Implants Appears Before Pain Symptoms Appear http://hub.am/YLVdT5
- Why telemedicine must become 'integral' to mainstream care efforts - FierceHealthIT http://hub.am/13Yt0JH #telemedicine
About Excalibur: Excalibur Healthcare is dedicated to Telehealth, providing quality offsite diagnostic interpretations to healthcare facilities nationwide.
We welcome guest posts... Pitch us first at streitfeld@excaliburmed.com!
Medical Imaging & Teleradiology in Today's ER Environment:
While many are quick to point to overuse of medical imaging as the culprit for the high cost of hospital emergency care today, the fact is that without rapid access to medical imaging results, diagnosis and treatment delays would be the norm and the cost of care would be even greater.
Medical imaging is critical to the diagnosis and treatment of all patients. The speed and accuracy of diagnosis would be significantly diminished without it, particularly in the case of emergency care. In a recent article entitled: Medical Imaging Critical To Improving Emergency Care: Q&A With Dr. Sandra Schneider Part 1 published on McKesson's Medical Imaging Blog, Dr. Sandra Schneider, an emergency medicine specialist and past president of the American College of Emergency Physicians (ACEP) speaks to this issue, among others. Dr. Schneider states: "...imaging helps us avoid admission to the hospital. Appendicitis is a great example. In the past it was appropriate for 30-50% of appendectomies to be performed on a normal appendix. Now that number is likely <10%."
It is ideal for the emergency departments to have 24/7 access to x-ray, CT, MRI and ultrasound. The reality is that many hospitals do not have round the clock on site staff for such purposes and teleradiology provides a viable option. It's important to work with a reputable provider with a dedicated group of US-based radiologists that is assigned to your facility, to ensure timely communications that lead to improved patient outcomes and fewer repeat scans.
Arthur Greene, MD, President of Excalibur Healthcare and board certified radiologist, says that the best possible outcomes occur when radiologists take a more active role in the real time consultation of patient imaging exams with the ED physicians. The environment in which this is likely to occur is when there is a prior relationship with the emergency staff and radiologist. The real time consultation provides the opportunity to define with greater precision the patient's clinical presentation with correlation to the imaging exams for a specific diagnosis and directive report to the clinician. This consultation is more important with the nationwide shortage of physicians, resulting in emergency medicine departments staff by non-emergency medicine trained clinicians and the use of other healthcare professionals such as nurse practitioners and PA’s.
With teleradiology, patients can quickly have diagnostic imaging interpreted without requiring a radiologist on site. Doctors can have access to interpretations 24/7/365 and begin patient treatment. Teleradiology services allow hospitals to treat patients round the clock. Other articles related to this topic:
Download To Learn More:
- jfcherry / Health Photos / CC BY-SA
What Stops Your Healthcare Organization from Implementing Telehealth?
Part 2: Regulatory Considerations
This is the second in our series of articles, which will provide information that attempts to break down the hurdles that limit Telehealth deployment. Our first article addressed cost considerations associated with initial start up of a Telehealth Program and reimbursement concerns. We've said it before, but it bears repeating that there is no one size fits all solution. However, we will demonstrate via this series that the hurdles are slowly being removed and access expanded.
Here are some of the topics to be covered throughout the series:
-
Initial Start-up Costs with Limited Reimbursement
-
Across State Licensing
-
Credentialing Restriction
-
Provider Acceptance
-
Patient Awareness
-
Security and Privacy
-
Managing Technology
-
Costs
-
Training
-
Connectivity and Networking
HURDLE #2
Regulatory Concerns, Across State Licensing and Credentialing and Privileging Restrictions:
Are you exploring the possibility of expanding access to specialists or increasing services to your community? Are you dealing with provider shortages in your region and trying to define the best way to offer your community the quality healthcare it merits? Launching a Telehealth program in your facility can be the answer. However you must consider the regulations on licensing and credentialing and privileging, established by your state’s licensing board as well as those stated in your facilities bylaws.
Photo credit Flickr by fdecomite
Licensure and credentialing and privileging provide the necessary oversight ensuring quality care while offering a safety net for your patients. While they are similar and have the same end goals, licensure is broader in scope as legislated by each state or federal government, while accreditation is at the local facility or organizational level. Each is defined below.
Licensure:
- Licensure: The granting of a permit to perform acts which, without it, would be illegal. The licensure of health care personnel traditionally has been the responsibility of the state licensing boards, governed by licensing statutes enacted by the state.
- While most states require that Telehealth practitioners become licensed in the state where the patient is located, there are some exemptions to this rule as per The Telehealth Resource Center:
- Physician-to-physician consultations (not between practitioner and patient)
- Educational purposes
- Residential training
- Border states
- U.S. Military
- Public health services
- Medical emergencies (Good Samaritan) or natural disasters
- For short term patient interactions, where the specialist is not responsible for the follow up and future care of a patient some states allow for an exemption, as long as the physician specialist is licensed in another state and is not barred from providing any services.
- While change is somewhat slow on this front, today there is legislation that is being put forth to facilitate various licensure models that allow greater flexibility for healthcare organizations to identify the necessary practitioners need to launch their Telehealth programs.
Two bills have been proposed in the past two years and their outcomes are yet to be decided:
- As reported by The California Telehealth Resource Center: In 2011 AB 415 was an update to the Telemedicine Act of 1996. It allows for the provision of a broader range of telehealth services, expansion of teleheatlh providers to include all licensed healthcare professionals, expansion of telehealth care settings and the ability for California hospitals to establish medical credentials for telehealth providers more easily.
- As reported by Fiercehealthit: In one of the latest efforts, Sen. Tom Udall (D-Utah) said he'll introduce a bill this spring to make it easier for physicians to practice telemedicine in many states instead of applying for a separate license for each state, according to a Government Health IT article. The bill would streamline licensure with a unified set of standardized data in a comprehensive and interoperable database of primary source verified credentials, Fern Goodhart, Udall's legislative assistant said at a briefing.
HRSA has also established a grant to explore the possibility of license portability:
- The Licensure Portability Grant Program (LPGP) is a competitive grant program that provides support for State professional licensing boards to carry out programs under which licensing boards of various States cooperate to develop and implement State policies that will reduce statutory and regulatory barriers to telemedicine.
To view other pending legislation and regulation you can also visit The National Telehealth Policy Resource Center up to date information as well as legislation specific to your state.
Credentialing and Privileging
Credentialing and privileging are conducted at the local facility level, payer requirements and CMS Condition of Participation. They are governed by your organizations bylaws.
- Credentialing: is the process of reviewing a health professional’s credentials, training, experience, or demonstrated ability, practice history and medical certification or license to determine if clinical privileges to practice in a particular place are to be granted. A much less frequent use of the term applies to closed panels and medical groups and refers to examination of the credentials of a physician or other health care provider to determine whether that provider should be entitled to clinical privileges at a hospital or managed care organization.
- Privileging: authority granted to a physician or dentist by a hospital governing board to provide patient care in the hospital. Clinical privileges are limited by the individual's professional license, experience, and competence. Emergency privileges may be granted by a hospital governing board or chief executive officer in an emergency and without regard to the physicians or dentist's regular service assignment or status. Temporary privileges may be granted a physician or dentist to provide health care to patients for a limited period or to a specific patient.
Telehealth providers would be credentialed and privileged similarly in process to the manner by which you would credential and privilege any other physician, once the licensure aspect is completed. While credentialing and privileging generally go hand in hand, you may have constraints on privileging based on a physician’s experience and the scope of the services you require. The process can be long and expensive. In order to reduce the complexity and expense of this process for Telehealth programs, CMS adapted a policy similar to TJC policy for credentialing by proxy. The Telehealth sites are defined; the providers are identified allowing the hospitals who are receiving Telehealth services to rely on the distance site providing the Telehealth practitioner’s meeting their credentialing and privileging requirements. A written agreement must be in place between the two sites to provide and receive services among other rules.
To Summarize...
These regulations can be reviewed with your organization’s needs in mind by visiting CMS, TJC and The National Center for Telehealth Policy. We agree with The American Telemedicine Association: The regulatory issues are tough to tackle, but with heightened awareness and advocacy behind Telehealth the momentum is heading in the right direction!
If your Healthcare Organization can benefit from more information, contact Excalibur Healthcare and we can work with you to set up a telehealth program or a small pilot project.
Equipment financing and leasing now available!
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Our Teleradiology PIN of the Week honors Wilhelm Roentgen, who discovered the X-Ray!
Wilhelm Conrad Röntgen (aka Roentgen) was born on March 27, 1845. Roentgen, a German scientist, accidentally discovered the x-ray in 1895, while studying the path of electricity. He noticed that the image was sticking to a paper and contained details not found in an ordinary photograph. After making a few adjustments, he took
the very first x-ray of a human hand. He would go on to win the very first Nobel Prize in Physics in 1901.To learn interesting details of the momentous event, check out:
Moments in Radiology History: Part 4 -- Discovering x-rays.
Other interesting facts about Röntgen and his discovery:
- X-rays are also known as Röntgen rays
- Röntgen also has an element, Roentgenium, named after him.
- Wilhelm did not show any special aptitude as a young child, but showed a love of nature and was fond of roaming in the forest. He was especially apt at making mechanical contrivances, a characteristic which remained with him also in later life.
- Roentgen didn't patent his discoveries, and he donated his Nobel Prize money.
We are very thankful for this discovery and honor Wilhelm Röntgen on his birthday!
To learn more check out:
Interesting Facts About the History of X-rays and Medical Imaging.
- jfcherry / Health Photos / CC BY-SA
What Stops Your Healthcare Organization from Implementing Telehealth?
Part 1: Cost Considerations
This is the first in a series of articles which will provide information that attempts to break down the hurdles that limit Telehealth deployment. This first article addresses cost considerations associated with initial start up of a Telehealth Program and reimbursement concerns. There is no one size fits all solution; however we will demonstrate via this series that the hurdles are slowly being removed and access expanded.
Here are some of the topics to be covered throughout the series:
-
Initial Start-up Costs with Limited Reimbursement
-
Across State Licensing
-
Credentialing Restriction
-
Provider Acceptance
-
Patient Awareness
-
Security and Privacy
-
Managing Technology
-
Costs
-
Training
-
Connectivity and Networking
(Feel free to comment and let us know if we should be adding to our list)
HURDLE #1
Initial Start-up Costs with Limited Reimbursements: Have you completed your needs assessment and found that your organization can provide additional services to your community if you could implement a Telehealth program? Maybe you have not conducted an assessment at all, fearing what startup costs would mean to your budget (infra-structure, equipment, personnel and training and education).
Grants and Financing
There are several grant programs offered by HRSA and USDA which may fit into your organizations Telehealth deployment plan. Possibly identifying grantees and determining if you have a project to collaborate on may enable your organization to determine the feasibility of your plan.
Other solutions can including teaming with an organization that can collaborate on a small pilot, share the work, provide some services at a low fee to demonstrate the service and establish a baseline for performance.
Reimbursements
The landscape is changing. Today we see a wider acceptance by the Centers for Medicare and Medicaid of Telehealth practices (CMS).
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Telemedicine is viewed as a cost effective approach to increasing access to quality healthcare versus the conventional face-to-face method.
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Defined HCPCS and CPT codes with modifiers are issued and can be selected by individual states to classify, monitor and reimburse for Telemedicine.
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Medicaid.gov: Telemedicine definitions and resources: For purposes of Medicaid, telemedicine seeks to improve a patient’s health by permitting two-way, real time interactive communication between the patient, and the physician or practitioner at the distant site.
Private Insurance
Certain states have mandated that private insurers should make Telehealth Services available when they provide similar coverage using traditional face-to face care. Sixteen states have private insurance coverage for Telehealth with several others waiting on pending legislation. Review of the regulations is necessary since they vary from state to state and from one insurer to the other.
States with Mandated Private Insurance for Telehealth*
*Source: 2013 National Conference of State Legislature (see site for detailed information)
This changing landscape can only help implementation of Telehealth programs.
Sustainable Funding
Sustainable Telehealth funding should develop internally, propelled by your community’s demands, driven by positive outcomes data and cost avoidance models to. A review of existing data both from the US and international programs can offer an understanding of the benefits seen in mature programs.
The Veterans Affairs Department plans to double the number of veterans reached through telehealth next year, according a report released Friday by Government Health IT. A goal of the initiative is to better manage chronic diseases. - See more at: http://www.nextgov.com/health/health-it/2012/11/veterans-affairs-pushes-telehealth-expansion/59246/#sthash.Bc4GMLwM.dpuf
Veterans Affairs pushes telehealth expansion
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Telehealth reduced readmissions, hospital days: (Nextgov) The Veterans Affairs Department plans to double the number of veterans reached through telehealth next year, according a report released Friday by Government Health IT. A goal of the initiative is to better manage chronic diseases.
The Veterans Affairs Department plans to double the number of veterans reached through telehealth next year, according a report released Friday by Government Health IT. A goal of the initiative is to better manage chronic diseases. - See more at: http://www.nextgov.com/health/health-it/2012/11/veterans-affairs-pushes-telehealth-expansion/59246/#sthash.Bc4GMLwM.dpuf
he Veterans Affairs Department plans to double the number of veterans reached through telehealth next year, according a
report released Friday by
Government Health IT. A goal of the initiative is to better manage chronic diseases. - See more at: http://www.nextgov.com/health/health-it/2012/11/veterans-affairs-pushes-telehealth-expansion/59246/#sthash.Bc4GMLwM.dpuf
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Interview: Lessons from a Leader in Telehealth Diffusion: Interview with Adam Darkins of the Veterans Health Administration (2010)-This article provides an overview of the Veterans Health Administration's telehealth program through an interview with one of the leaders in its use and diffusion. Programs like this, and the strategic and operational considerations in their implementation, can be used as models by nongovernmental health systems interested in adopting telehealth solutions to address their patients needs.
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UK telehealth success could lead the way for Europe: (PMGroup Worldwide Ltd 2013): A UK telehealth pilot that reduced mortality rates by a striking 45 per cent could point the way for the technology to be used more widely across Europe.
If your Healthcare Organization can benefit from more information, contact Excalibur Healthcare and we can work with you to set up a telehealth program or a small pilot project. Contact us today to learn more about our customized telehealth solutions .
Equipment financing and leasing now available!
Top Ten Questions to Ask Before Renewing Your Current Teleradiology Contract
Renewing a teleradiology contract? Are you using the right company for your teleradiology solution? Here are some important questions to ask yourself and your staff prior to your next contract renewal.
#1: Are you staying with your current provider to avoid the hassle of credentialing new physicians?
Working with a provider that is JCAHO Accredited means that you can utilize “Credentialing by Proxy”. CMS allows the governing body of a hospital or CAH (Critical Access hospitals) whose patients are receiving telemedicine services to grant privileges in reliance on the credentialing and privileging decisions made by the distant-site hospital. This also permits hospitals and CAHs to rely on credentialing and privileging decisions made by “distant-site telemedicine entities,” such as teleradiology groups and ambulatory surgery centers. Excalibur Healthcare is Joint Commission accredited and strives to provide reasonable assurance that our doctors meet or exceed hospital or CAH requirements.
#2: Is your teleradiology provider able to provide you with final interpretations?
With a roster of US based, board certified, fellowshipped radiologists, trained at reputable medical institutions means that you have access to final interpretations. Final interpretations provide the most cost-effective use of your teleradiology dollars and decrease the workload for your current radiology group by eliminating the need for re-reading the overnight exams.
#3: Is your current provider physician owned and operated?
Physician owners empathize with your clinical requirements and are more responsive to your needs as a practicing physician. Many of the largest teleradiology companies are publicly held corporations run by businessmen responding to the demands of the stockholders rather than to your needs. When you have a clinical need, having a physician respond directly to your request rather than a corporate entity leads to a more patient-centric response.
#4: How responsive is the company to your questions and concerns/are you able to call the corporate office and ask to speak with the owner/CEO?
Having direct access to the business owner leads to a more personalized approach to addressing your needs. This streamlines the process and cuts down on any delays that may be experienced when dealing with a corporate entity that must answer to a board to affect change.
#5: Does your remote radiology service provider give you the flexibility you need?
We know that there are situations when practices/facilities face unexpected staffing shortages and nighthawk services are not enough. At those times you need a partner that is able to provide interpretations for daytime reads as well. If you current solution does not provide you with back up/overflow-services with a single phone call, you need to change to a company that can meet your demand at a moment’s notice.
#6: Ask your staff how they view your current provider.
We know that many times the in-house staff can provide the best insights as to how we are doing. It’s important that you consider their feedback at contract renewal as well.
#7: Technologists: Are the radiologists accessible for questions or suggestions on scanning protocols?
Radiologist support is essential when there are patients awaiting scans. A dedicated group of radiologists should be assigned to your practice to facilitate timely communications that lead to improved patient outcomes and fewer repeat scans.
#8: Practice Manager: Are the reports timely and is the quality of service consistent?
Often the Practice Manager is the one who must apologize to the referring physicians if there is a delay in report availability. Consistency is key to maintaining your referral base. There is nothing more important than receiving quality, timely reports from a partner you can trust to deliver 24/7/365.
#9: Physicians: Are they happy with the reports they receive and are the radiologists readily available for consultations should they have questions?
A designated group of radiologists assigned to each client, who are available to discuss patient history and symptoms facilitates the highest quality reports and best possible patient outcomes. Having a smaller cadre of radiologists reduces the burden of credentialing a large number of physicians and allows for a closer working relationship with your staff. These physicians actually get to know your clinicians and technicians and you get to know them. Your radiologists should be a phone call away and services should be the same as if they were just down the hall…if not, a new solution is in order.
#10: Are you getting the most out of your current telerdiology service provider?
A quality provider is there for you 24/7/365. Value added services should be part of the package, such as assistance with ACR Accreditation and the development of imaging protocols. Service, efficiency, accessibility and costs must be carefully evaluated. If you have question marks in any or all of these areas, we ask you to consider an alternative teleradiology solution… Excalibur Healthcare.
If you find that your current teleradiology provider isn’t serving your needs 100%, contact Excalibur. You will be able to speak with our owner, a board certified radiologist, who understands the demands of your practice or facility, because he has been in your shoes. Our team will provide you with a needs assessment and customized teleradiology solution, designed to solve your unique challenges. Our approach is not one-size fits all. We know that your requirements are unique and we take the time to get to know you and your staff and you have the opportunity to know us as well. Our relationships are what set us apart from our competitors…we are here for you!
Radiology services can be confusing for patients. This infographic by Concordia University, St. Paul is a great resource for patients and can serve as a guide for commonly used imaging techniques.
Concordia University St. Paul - Online
Excalibur Healthcare understands that patients require information to understand the complexities of diagnostic services. As a physician owned telemedicine practice, focused on teleradiology services and telehealth solutions, we are here to provide the educational resources our clients and their patients require. Please visit our Learning Center for information geared towards medical imaging professionals and patients. We are here for you!
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Romance and Radiology...not necessarily a match made in heaven!
Our Teleradiology PIN of the Week honors a couple who spent what was meant to be a romantic evening, in a hospital emergency room when a marriage proposal went wrong. A New Mexico man’s attempt to create a romantic marriage proposal didn’t go as planned, when his girlfriend swallowed the diamond engagement ring he had hidden in her milkshake. It took a trip to the hospital emergency room and the X-ray, above, for Kaitlin Whipple to believe her boyfriend, Reed Harris’, tale of what happened. (Source: New York Daily News)
Harris did get a second chance at a proposal, this time with the X-ray inhand, Harris got down on one knee and popped the question. Whipple said yes. Two days after the trip to the ER, a bag of prunes and a box of high-fiber breakfast cereal helped Whipple get her ring back. On her blog, krazykaitlin.blogspot.com, Whipple wrote: "It arrived this morning and I have never been so excited about my bodily functions. Haha. It's so beautiful and I love it. It was definitely well worth the wait."
Have a wonderful Valentine's Day and remember that if a medical emergency occurs, our board certified radiologists are here for you 24/7/365! We serve medical facilities nationwide including: hospitals, medical clinics, government facilities, and mobile imaging providers.
To learn more about our teleradiology services, check out our teleradiology video.
Be sure to visit us on Pinterest, where we share pictures and stories related to telemedicine, telehealth, radiology, patient and veteran's resources and what interests & inspires us!
With a weekend snowstorm in the weather forecast for the Northeastern U.S., Excalibur would like to remind you that our radiologists are available 24/7/365...even in inclimate weather. If your facility experiences staffing shortages for any reason, our teleradiology services can provide off-site coverage to back-up to your in-house staff. Please contact us to learn more!
We invite our clients and friends to submit their favorite snowman pictures. Here's some radiology-inspired ideas:
Check out more radiology humor on our Pinterest board! Have a safe and enjoyable weekend and remember that Excalibur is here to provide high quality radiology interpretations 24/7/365 ...we are here for you! The US Postal Service may be cancelling their Saturday hours, but we will not!
