Teleradiology providers are using diverse strategies to define their future role in the industry.

Several years ago, I read about Zappos, the company that sells shoes exclusively online. I thought, ?Now that?s never going to work.? People want to try on their shoes before they buy them for comfort and the right fit. But boy, was I ever wrong. Today, Zappos is a thriving online retailer. The key to their success: Free shipping and returns along with superior customer service.

Zappos is a prime example of changing business models. Remember the dedicated shoe store? Shoes were the only thing they sold, the salespeople were experts, and they even measured your foot with one of those metal gadgets, so you?d walk out with the perfect fit. But eventually, everyone started shopping for shoes at department stores; we seemed to get along fine without the expertise or the measuring gadget. Now, you can log onto and get the perfect pair of pumps without leaving the house.

Changing business models are a fact of life. While the evolution seems to have worked for the shoe business, it?s far more complex for teleradiology, which has evolved from a backup, nighttime service to a sophisticated industry. (See the feature article by Renee Diiulio.)

Teleradiology providers are positioning for business more than ever before?and they are doing so in varied and interesting ways. Some make no bones about maneuvering for market share, bypassing local radiology practices and seeking out hospital contracts directly. Their mantra: Competition is healthy and will result in better quality and service for hospital customers.

Others, rather than being a thorn in the side of radiology practices, are extending an olive branch. In mid-May, NightHawk announced its ?Commitment to the Radiology Community,? which the company calls ?a clear alternative to the growing predatory practices within teleradiology.? The company has outlined specific conditions that must be met in order for it to do business directly with hospitals or indirectly by providing services to non-radiologist-owned entities. NightHawk?s tactic: With transparency and accountability, the company hopes to rebuild trust with radiologists. (To learn more about NightHawk?s ?Commitment to the Radiology Community,? see the video featuring the president and CEO, Dave Engert, at

Then there are the really out-of-the-box business models. Telerays is an online auction that works a bit like eBay. Hospitals post interpretation requests and radiologists bid on them. The lowest bidder wins. For those concerned that teleradiology can lead to commoditization of the profession, Telerays is pretty much the definition of it.

Through various strategies and shifting business models, teleradiology providers are making their names and staking their claims. Meanwhile, many radiologists are still skeptical, saying there is a place for teleradiology, but a limited one at best.

Whether it is as competitor, partner, or out-of-the-box alternative, teleradiology providers all have the same long-term goal: They are trying to find a way to fit into the future of radiology. So far, there doesn?t seem to be any perfect fit. ?Read our special report, ?Changing Business Models,? and let us know what you think about teleradiology providers and their role in the future.

Marianne Matthews

Marianne Matthews