Sunday, March 02, 2008
Local company has x-ray vision
Specialized Radiology Services Inc. in Roanoke County connects hospitals and imaging centers with radiologists off-site.
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Patients who land in the emergency room after hours might be surprised to find that their X-rays are being read by radiologists thousands of miles away.
But that's exactly the kind of service one Roanoke company is looking to capitalize upon as it takes its operations global.
Specialized Radiology Services Inc., a 2-year-old company with offices in Roanoke County, is making its mark in this fast-growing subset of medicine that helps connect hospitals and imaging centers with radiologists off-site.
The company contracts with radiologists scattered throughout the country to read images sent to them via a secure Internet site and return a report -- sometimes within hours.
Right now, Specialized Radiology Services interprets images for about a dozen hospitals nationwide, but it plans to enter the international market by the end of this year by opening an office in Dubai.
"What we're doing is curbing a shortage," said Shehnaz Pancholi, 34, the company's co-founder and chief executive officer. "We're taking these specialist physicians that are highly trained and, instead of taking care of one hospital, they're taking care of 20."
'Nighthawking' named after pioneer
Teleradiology -- a specialty some experts say is less than a decade old -- has become the standard in more than 1,500 hospitals and health clinics across the country, said Jon Linkous, executive director for the American Telemedicine Association in Washington, D.C.
A shortage of radiologists has made it difficult for hospitals in underserved areas to staff their radiology departments around the clock, industry experts say.
Better technology for electronically storing and transmitting digital images has also helped fuel the industry's development, with some companies basing their radiologists in countries such as Australia, India and Switzerland.
The time difference allows these services to provide nighttime readings for U.S. doctors.
The concept is often referred to as "nighthawking," named after the company that helped pioneer the concept, Nighthawk Radiology Services based in Coeur d'Alene, Idaho.
Linkous estimates there about 20 companies offering teleradiology services exclusively, but an increasing number of independent radiologists are examining images at home in the off-hours, he said.
"There is a lot of the market you just don't see by just looking at the big companies," Linkous said.
The Roanoke company, however, plans to use only U.S.-based and board-certified radiologists, rather than sending the work overseas.
The company has two divisions: one for adult radiology; and the other for pediatrics, a niche market in the industry.
Between the two divisions, Specialized Radiology Services has more than 20 radiologists in its network -- 11 of them focusing on pediatrics. There are another dozen employees in its Roanoke office off Electric Road.
In 2007, Specialized Radiology Services spun off a second company, which specializes in reading cardiac images such as electrocardiograms and cardiac CT scans.
In fact, Pancholi noted that the market has already become so saturated by companies offering adult radiology services that "we're trying to break away from that."
CEO has become teleradiology's first lady
A business school graduate, Pancholi first entered health care from the marketing and sales side.
In 2003, she took a job as director and vice president of sales for American Teleradiology Networks, which brought her husband to Roanoke from Boston.
Two years later, the company merged with Nighthawk, which is when Pancholi decided to follow her own vision of establishing a company dedicated to pediatric radiology.
Having nearly completed her master's degree in pediatric nursing, she said she felt particularly close to the field. It also happened that there was a strong demand for pediatric radiology.
Pancholi said that when hospitals heard of her plans to launch a teleradiology service dedicated to pediatrics, they immediately wanted in, even before she had a chance to finish the market research.
"I had to tell them this is just a market analysis," she said.
In 2006, Pancholi created the company, along with its two divisions -- Pediatric Radiology of America and TeleradiologyAmerica. Her husband, Paras Yasin Pancholi, 36, helped her establish the company and works at its chief technical officer.
Her success in making the leap from sales to CEO was noted last year when she was named one of 25 "movers and shakers" in the radiology industry by Image, a weekly trade magazine. The magazine also nicknamed her "telemedicine's first lady."
The company is also making strides financially, pulling in about $1.5 million in revenue last year with a 25 percent to 30 percent profit margin, Paras Yasin Pancholi said.
Industry fights a stigma of being impersonal
Meanwhile, the teleradiology industry in the past couple of years has moved toward specialization.
For some hospitals, especially those in rural areas, this shift has meant more options for doctors who need X-rays read in fields such as cardiology and pediatrics.
"An X-ray is not just an X-ray. Essentially they require some level of expertise," said Jim Amato, radiology administrator for the University of Virginia, adding that most radiologists are grouped according to the point of anatomy being scanned.
At the same time, outsourcing such medical expertise gives some doctors pause.
Dr. Bill Kiser, who practices with Radiology Associates of Roanoke, said in-house radiologists might feel some competitive pressure from off-site readings.
"It's just like the jobs that go south to Mexico. We could outsource ourselves," said Kiser, who is also the radiology director at Lewis-Gale Medical Center in Salem.
But he added that such options are a product of the digital age, and that the Roanoke practice uses Nighthawk's services to cover its preliminary reads overnight. The group's radiologists then perform a final examination of those images the next day, he added.
Carilion Clinic also uses Nighthawk.
Pancholi acknowledged that teleradiology still fights the stigma of having a less personal touch than the face-to-face interactions in the doctor's office.
But she noted that the service's value resides in its ability to offer highly trained specialists to patients without having to travel.
And breaking down the industry into subspecialities can improve patient care, Linkous said, adding: "Frankly, with our experience in telemedicine, when you have someone specialize in only one area the quality increases immensely."
