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24 Sep 2005
By Dr Balaji Sadasivan, Senior Minister of State for Information, Communications and the Arts and Health
Venue: Mount Elisabeth Hospital
Distinguished Guests
Ladies and gentlemen
Good morning. It is my pleasure to be here today for the launch of Mount Elizabeth Hospital's new CT Centre.
Radiology has come a long way. Since 1895, when x-ray was first discovered by Professor Wilhelm Roentgen, advancements in technology have immensely transformed the field of Radiology and its applications in medicine.
For the first fifty years of radiology, film cassettes were used and a simple head x-ray could take up more than 10 minutes of exposure time. This also meant a considerable dose of x-ray exposure. The images produced then also had poor spatial resolution and contrast detail. Furthermore, considerable storage space had to be allocated to keep the x-ray films.
The introduction of digital imaging techniques in the 1970s however began a transformation in radiology that we still reaping the benefits today. With digital imaging radiologic images could be enhanced with minimal x-ray exposure. Images can also be archived using minimal storage space. The concept of Picture Archiving and Communications System (PACS) was thus developed and introduced almost concurrently in America and Europe.
In America, Computer Tomography and digital subtraction angiography were the first clinical applications of digital radiology. Analog to digital converters were also adapted for conventional fluoroscopic image intensifier systems and ultrasound. Currently, plain x-ray films are also being digitised. Eventually, all film cassette systems will be replaced by digital x-ray detectors.
Leveraging on the availability of digitised images and info-communication networks, radiologists may now access radiologic images with greater convenience and speed virtually anywhere in the world via teleradiology. US hospitals have taken advantage of this development by engaging night-time image reporting services that are manned by "nighthawk" radiologists located on the other side of the globe. This meant fewer radiologists are needed to go on night calls. Even daytime teleradiology services are growing rapidly, with overloaded and remote hospitals being early adopters.
In Singapore, teleradiology is still at its infancy stage. As a start the National Healthcare Group is planning to engage the services of a teleradiology provider in India to report routine films on a pilot basis. This is a first step in teleradiology for Singapore. Teleradiology promises three benefits.
First, by outsourcing the reporting of routine films to other lower cost countries, we are able to lower out costs for these tests while freeing our radiologists to handle more challenging and demanding tasks such as interventional procedures and more complex high end tests such as those undertaken by this CT centre.
Second, our ability to send radiological images overseas also means that we can receive such images from other countries. Coupled with the high international standing of our radiologists, teleradiology puts us in a good position to plug into the global market for radiology services, especially for reporting and/or second opinions for higher end tests such as in neuroradiology for countries in the region where such expertise may be limited or even countries such as America.
Third, the job opportunities for our radiologists increases significantly. I understand that there are concerns among younger radiologists that teleradiology may affect their career prospects. This need not be the case. As teleradiology becomes globalised, the market for our radiologists expertise also becomes global but without them having to move out of Singapore. Hence, we need to cast our sights far and wide and capitalise on the new work opportunities created by teleradiology.
To reap these benefits we must ensure that we start out on the right footing. We need to put the proper systems and processes in place. Teleradiology and outsourcing of radiology reporting services should not affect the quality of care for our patients but should instead enhance it. My Ministry is therefore working with the College of Radiologists of the Academy of Medicine to develop the necessary framework such as accreditation and audits to ensure that our patients continue to benefit from good quality reports.
Appropriately utilized, teleradiology offers great potential for healthcare in Singapore both in terms of patient care and economic opportunities for local providers and radiologists. The lessons learnt and the infrastructure that we develop for teleradiology would also provide us with a head start for other areas of telemedicine such as telepathology. The future holds great possibilities if we are able to innovate and assure our patients of the best care provided in a caring environment. The private sector is in a good position to be an early adopter of teleradiology . There are new business opportunites that teleradiology offers and your challenge is to seize these opportunies and stay ahead.
On this note, I congratulate Mount Elizabeth Hospital for the launch of its new CT Centre. This centre would enhance the hospital's patient care capabilities and I am confident that the hospital and its patients will benefit significantly from this new facility.
Thank you.