The Telerad Centre was initially set up in Manila in 2012 as a response to the growing demands of the various IOM migration health assessment projects. In line with new technologies, IOM has been strengthening its capacity in diagnostics of pulmonary tuberculosis with the use of digital radiology systems.   

In line with this initiative, the Migrant Health Division has been working with ITC Manila on the Global Teleradiology (Telerad) Centre as the project relies heavily on technology and infrastructure.  

The Telerad centre is charged with standardizing and optimizing the quality of the radiology process and results in health assessment projects via: 

• Primary reading chest x-rays 
• Quality assurance of chest x-ray readings and analysis 
• Second opinion and confirmatory readings 
• Radiology guidelines, support, training and research 

Wherever possible, the project uses standards-based healthcare software to achieve its goals.  

Primary Reading Workflow 

1. Once an x-ray image is taken it is uploaded to either the local mission PACS (Picture Archiving and Communications Server), a specialist server for archiving x-ray images (currently 24 Missions have local PACS Servers). 
2. The system is configured to transmit the image to the Global PACS server located in Manila (if a Mission does not have a PACS server they can upload direct to the Global PACS). 
3. The x-ray image is then queued for reading by a radiologist in the Telerad Centre. 
4. The radiologist then logs into the Telerad application and selects the x-ray image to view. 
5. The system displays the x-ray using a commercial package called the Remote Eye viewer  
6. They then complete the report in the Telerad system and notify the Mission. 
7. The local Mission radiologist then logs into to the system, views the results and then either copies them into MiMOSA or uploads the x-ray and records the results into a non-IOM system called eMedical which is used by the health departments/ministries of countries such as Australia, Canada, New Zealand). 

Quality Assurance Workflow

To ensure that that IOM maintains a high quality and consistent x-ray reading standard that our donor partners can rely on, a Quality Assurance workflow has been built and is configured to take a percentage sampling from each Mission's local PACS server and put them into the Quality Assurance queue. The Global Telerad Centre radiologist will then select x-ray images from the queue, review the x-ray findings and write a report on the results for the Mission.  

In 2014, as a result of this high quality and consistency, the Canadian Health Department (Philippines) requested IOM to perform primary x-ray readings for all clinics in the Philippines that handle Canadian Health Assessments, with the possibility of rolling out this facility to the South-east Asian region. ITU and Migrant Applications Unit (MAU) worked closely with the Telerad Centre to put in place the infrastructure to handle the increased volume. The Telerad Centre established a training curriculum for non-IOM clinics and trained and piloted the curriculum in Nationwide Health Systems in Davao in March 2015. To date, three more non-IOM clinics are now using IOM as the primary x-ray reader.  

Enterprise Solution 

With the expansion of Telerad, it was decided to move the application to a more enterprise-capable solution that took advantage of IT standards and capacity of a larger team (the original application had one developer providing both support and development). As such the responsibility for ongoing development and support of the application was transitioned to the MAU and at the same time, ITU staff members were trained to assist in supporting the infrastructure in early 2015. In coordination with the Telerad Centre, MAU has been developing the next generation of the application and building upon the operational lessons learned since the deployment of the original application as well as looking at options to better integrate the system with MiMOSA and the eMedical application used for Australia, Canada and New Zealand health assessments.