A team of researchers has found that for outsourced radiologists at teleradiology companies, customer-specific experience has a greater impact on performance than general experience.

Jonathan Clark, assistant professor of health policy and administration at Penn State, said, "We expected the rate of learning associated with a specific customer to be faster than the rate of learning associated with all other customers, and that's exactly what we found. That is not to say that experience with other customers doesn't matter; it does, and our findings show that. Rather, it is to say that prior experience with a specific customer is more important."

The majority of hospitals now use teleradiology in one form or another. According to a 2009 study by VHA Inc., a network of community-owned health systems, 56 percent of U.S. hospitals use it. Yet even as an increasing number of hospitals turn to teleradiology, many critics have raised doubts over whether teleradiology firms are able to provide the same levels of service and quality as in-house radiologists, who may be more attuned to the nuances of reading images at a particular hospital.

On the other hand, teleradiology supporters argue that teleradiologists gain substantial experience over time reading hundreds, or sometimes thousands, of images from many different hospitals and facilities. Researchers at Penn State wanted to find out whether this kind of experience was truly equivalent to the kind of experience gained from working with only a few hospitals.

To answer this question, the research team, which included Robert Huckman of the Harvard Business School and Bradley Staats of the University of North Carolina at Chapel Hill, evaluated the productivity and learning curve of 97 radiologists reading over 2.7 million images from 1,431 hospitals.

The researchers found that prior customer knowledge gained by individual radiologists had a greater effect on performance than experience gained by reading the same type of image for other customers. However, they also found that performance gains from prior customer knowledge are also enhanced by general experience working with a variety of customers.

According to Clark, the differences across hospitals may have something to do with both the task of capturing images and the communication between the hospital and the outsourced radiologist. Clark explains: "For example, in terms of the image itself, there may be some differences in how patients are positioned for image capture or in how measurements are taken, for example from ultrasound. In terms of communication, there may be differences in how ordering physicians note the medical question of concern or in how the overall request is transcribed, packaged and delivered."

The results of the study appeared online on December 20, 2012 in the journal Organization Science.

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