Summary
A veterinary teaching hospital reading remotely needs a different setup from a private practice buying outsourced reads. The service has its own attendings and residents, studies arrive from more than one campus or service line, and every report has to show which attending reviewed it. What it needs is a platform the radiology service runs itself: routing rules it controls, a separate queue for attending review, supervised resident reporting, and a viewer that handles cross-sectional work in the browser.
Why does outsourced teleradiology fit academic services poorly?
Per-study teleradiology solves a coverage problem for private practices. An academic service has a different one. When a resident drafts a report, the program needs that report reviewed and signed by a named attending on its own staff, so the resident gets feedback from someone they work with and the program can see who supervised what. A shared external reading pool breaks that link.
So the radiology service needs to own the workflow, not rent reads. Reads stay inside the institution's own NewLumen account and are signed by its own attendings. NewLumen runs on Google Cloud, with a separate storage bucket for each clinic and patient data kept in the clinic's home region, so the service gets remote reading without running a server room.
How does worklist routing work across campuses?
A basic PACS worklist is a chronological queue: the next free reader takes the next study. That works when every study is equally urgent and every reader covers everything. A teaching hospital with several campuses, service lines and subspecialty attendings does not work that way.
In NewLumen each campus or hospital can be set up as its own clinic, and the radiology service decides how studies reach readers. Routing can be static or algorithmic. Rules can match:
- the sending clinic, so each campus can route differently
- modality, so CT and MRI reach the attendings who report them
- body area
- priority
- time of day and day of week, so out-of-hours studies follow the on-call rota
The first matching rule wins, and any case can be reassigned by hand. Each priority carries an SLA deadline that the service sets, and an unclaimed stat case escalates to a wider pool of readers.
Attendings and residents work from one login across every connected clinic, with five worklist views: All Cases, My Queue, Group Queue, Pending Review and Completed Today. Pending Review is where drafts wait for an attending. For more on how routing, viewing and reporting connect, see the NewLumen teleradiology overview.
What does species-aware viewing do, and where does it stop?
An academic service reads across species in a single shift, and each species has its own normal anatomy and its own conventions for laying out views. A viewer that opens everything with one default layout makes the reader rearrange each non-standard case by hand.
NewLumen has five species-tagged hanging protocols: Canine Chest 3-View, Canine Abdomen, Canine Orthopedic, Feline Chest 3-View, and Feline Thorax and Abdomen. They apply when a study opens, even when the DICOM tags are inconsistent. Priors for the same patient surface when the case opens, so comparison is already on screen.
The automation is canine and feline only. Equine studies are viewed and reported in NewLumen, but there are no equine protocols, and avian and exotic studies open without species-specific layouts. For a service with a large equine or exotics caseload, that is worth knowing before you plan your workflow.
For cross-sectional work, the viewer runs in Chrome or Edge on Cornerstone3D with no install or VPN. MPR and 3D are layout modes inside the same viewer. On a full canine CT thorax of 1,385 images, switching to MPR takes under three seconds and a 3D render under five, depending on the connection and the device. Multi-monitor reading uses the browser's Window Management API in Chrome and Edge. Our post on web-based DICOM viewing for cross-sectional imaging goes into the viewer in more detail.
How does supervised resident reporting work?
This is the part of the workflow academic services ask about most.
A resident drafts the report in NewLumen. The draft never promotes itself to a final report: it waits for an attending, who reviews, edits and signs. Once finalised, the report cannot be edited. A later change goes in an addendum with a reason, linked to the original, so the record shows what was changed and why.
Reports follow a fixed structure: clinical history, technique, comparison, findings, impression and recommendations. The service starts with 17 system templates and 13 system macros across canine, feline and equine work, and attendings and residents add their own personal macros. Signing delivers the report by link email, PDF or automated delivery to a connected practice management system.
Access runs through the institution's identity system. NewLumen supports single sign-on (OIDC and SAML), SCIM provisioning so accounts follow the university directory, and multi-factor authentication, with encryption in transit. See NewLumen for academic services for how a teaching hospital is set up.
Where do AI tools fit in an academic service?
The ACVR and ECVDI position statement on AI says AI systems should always be used with a qualified veterinary professional in the loop. In a teaching hospital that loop has two people in it, the resident and the attending, and no AI output changes that.
NewLumen has two AI features. Priority Triage flags urgent studies in the worklist, so they are not left behind routine work in a resident's queue; it does not diagnose. Report Assist pre-structures report sections by species and modality; the resident or attending writes the content and the attending signs. Each feature is billed per clinic through the AI Marketplace, so a service can turn on one, both or neither.
What should a radiology director check before choosing a platform?
- Routing: can the service write its own rules by clinic, modality, body area, priority and time, and reassign by hand when it needs to?
- Supervision: does a resident draft stay a draft until an attending signs, and are finalised reports protected from editing?
- Viewer: do MPR and 3D run in the browser on the machines your attendings already use, and how fast on a full CT?
- Species coverage: which species have automated hanging protocols, and which open without them?
- Identity: does the platform work with your university's single sign-on and directory?
For the broader architecture question, our cloud vs on-premise PACS guide compares the two approaches.
FAQ
What is remote veterinary radiology at a teaching hospital?
It means the hospital's own board-certified radiologists read and sign studies from wherever they are working, on a cloud platform the radiology service runs itself, while residents stay part of the reporting workflow. The difference from outsourced teleradiology is that the reads stay within the institution: the attending who signs is a member of the service's own staff, not a reader from an external pool.
Can AI replace the attending radiologist in an academic service?
No. The ACVR and ECVDI position statement says AI should always be used with a qualified veterinary professional in the loop. In NewLumen, Priority Triage flags urgent studies in the worklist and Report Assist pre-structures report sections. The attending reviews the images and signs every final report.
How is an algorithmic worklist different from a standard PACS worklist?
A standard worklist is a single queue in order of arrival. An algorithmic worklist routes each study by rules. In NewLumen, rules match the sending clinic, modality, body area, priority, time of day and day of week, the first matching rule wins, and any case can be reassigned by hand. For a hospital with several campuses, the right study reaches the right attending without someone sorting the queue.
Does NewLumen apply hanging protocols for every species?
No. NewLumen has five species-tagged hanging protocols, for canine and feline chest, abdomen and orthopedic studies, and they apply when a study opens. Equine studies are viewed and reported, but there are no equine protocols, and avian and exotic studies open without species-specific layouts.
What should a radiology director look for in a cloud PACS for a teaching hospital?
Five things: routing rules the service controls, a review step that keeps resident drafts as drafts until an attending signs, MPR and 3D in the browser without a separate workstation install, clear species coverage for hanging protocols, and support for the university's single sign-on and directory. At academic volume, the time each case costs to route, read and supervise matters more than the price per study.