Evaluating the quality and safety of the BreastScreen remote radiology assessment model of service delivery in Australia

Lindsay, Daniel, Bates, Nicole, Callander, Emily, Johnston, Karen, Carlisle, Karen, Smith, Deb, Evans, Rebecca, and Larkins, Sarah (2023) Evaluating the quality and safety of the BreastScreen remote radiology assessment model of service delivery in Australia. Journal of Telemedicine and Telecare, 29 (3). pp. 203-210.

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Breast cancer is the most commonly diagnosed cancer in Australian women. Given the diverse geography and populations within Australia, the ability to offer a telemedicine-supported breast screening and assessment service may increase access. The aim of this study was to assess clinical outcomes of a telemedicine-based remote radiology assessment service delivery model for detecting breast cancer in regional Australian women compared to the traditional radiologist onsite model.


This study was a pre–post intervention study using de-identified administrative data. Data were collected from seven sites across three health jurisdictions within Australia. There were a total of 21,117 assessment visits, with 10,508 (49.8%) pre- and 10,609 (50.2%) post-remote model implementation. Of the 10,609 post-remote model visits, 3,904 (36.8%) were under the remote model. The main outcome was cancer detection, split into any cancer, any invasive cancer or any small invasive cancer. Timeliness of assessment was also examined.


After adjusting for multiple factors, there were no statistically significant differences in cancer detection rates between the remote and onsite models (adjusted odds ratio (AOR) = 1.02, 95% CI 0.86–1.19, n.s.). Implementing the remote assessment model had statistically significant positive effects on the timeliness of assessment (AOR = 0.68, 95% CI 0.59–0.77, p < 0.001).


This study found the remote model delivers safe and high-quality assessment services, with equivalent rates of cancer detection and improved timeliness of assessment when compared to the traditional onsite model. Careful monitoring and ongoing evaluation of any health-service model is important for ongoing safety, efficiency and acceptability.

Item ID: 65416
Item Type: Article (Research - C1)
ISSN: 1758-1109
Keywords: Tele-oncology, Telehealth, Cancer services, Regional health care, Breast cancer
Copyright Information: © The Author(s) 2020
Funders: Australian Government Department of Health (AGDH), Queensland Department of Health (QDH), New South Wales Department of Health (NSWDH), Northern Territory Department of Health (NTDH)
Date Deposited: 06 Jan 2021 23:46
FoR Codes: 32 BIOMEDICAL AND CLINICAL SCIENCES > 3211 Oncology and carcinogenesis > 321102 Cancer diagnosis @ 20%
42 HEALTH SCIENCES > 4203 Health services and systems > 420317 Patient safety @ 40%
42 HEALTH SCIENCES > 4203 Health services and systems > 420321 Rural and remote health services @ 40%
SEO Codes: 92 HEALTH > 9205 Specific Population Health (excl. Indigenous Health) > 920506 Rural Health @ 50%
92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920102 Cancer and Related Disorders @ 20%
92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920412 Preventive Medicine @ 30%
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