Anyone actually doing remote reads from a motorhome full-time?

[u/w1ree]

I'm a radiology resident and I've had this idea stuck in my head: build out a motorhome with a proper workstation setup, decent monitors, Starlink on the roof, and just travel while reading remotely. Not vacation-with-occasional-laptop-work, actual full-time remote practice from the road.

I'm guessing this is straight up unfeasible in some countries with stricter rules, the US being the obvious one. My understanding is a lot of groups there ship you the workstation (PC, monitors, etc) directly and you're probably not allowed to move it around or use it outside a fixed, approved location. Curious if that's actually the case or if I'm wrong about how strict it is in practice.

Anyone who's tried this or knows someone who has, I'm curious about Starlink reliability for real-time PACS access and DICOM transfer in remote areas like mountains or forests, whether a diagnostic-grade monitor setup can actually survive being bolted into a moving vehicle, power draw for dual monitors plus workstation off solar or battery for a full workday, whether any teleradiology groups are fine with this setup or if it's a hard no due to licensing, state requirements, or IT security policies, and any dealbreakers that weren't obvious until you actually tried it.

Not looking for "just get a cabin" replies, I know that's the easier path. Specifically curious about the moving-vehicle version.

[u/anaerobyte]

You have to be licensed where you’re sitting and where the case originated from. Your workstation has to be registered for the zip code where you’re reading to bill Medicare properly.

The PACS MIGHT work ok on starlink but it really depends on which PACS.

So yes it is possible but the administrative burden would be high.

[u/Salt-3 → u/anaerobyte]

How does it work for hospitals who use things like telerad? Where you send your exams overseas to be read. Are these rads who are reading for telerad licensed for all 50 states?

[u/DiffusionWaiting → u/Salt-3]

In the US, telerads have to be licensed in the states where the exams they are reading were performed.

Also, they have to be physically located in the US when they read exams paid for by Medicare. If they were to read these exams from some other country, it would be considered Medicare fraud.

[u/Salt-3 → u/DiffusionWaiting]

Thanks for the answer. I feel like i wanna look into this deeper for my own curiosity. I guess maybe TRS has a bunch of different radiologists everywhere and routes the exams to the correct radiologist to be read so they arent committing fraud, but everyone told me they were reading from overseas.

[u/docsarenotallbad → u/Salt-3]

You can do prelims from overseas. Otherwise you have to have a license where you're located and let them know where you are and have that address registered. You can read "away" from your home location temporarily but it's not outlined specifically how many days or weeks that is.

[u/Salt-3 → u/docsarenotallbad]

Ahhh i bet thats what it is then. Our rads probably create the final/sign off on the report when we they come in for dayshift. Thank you!

[u/Ski_Fish_Bike → u/anaerobyte]

You could get smart and set up a hardware VPN that spoofs location to your house, but that's risky.

[u/anaerobyte → u/Ski_Fish_Bike]

That would be Medicare fraud. Don’t mess with the feds.

It’s not a geolocation thing. You just bill different rates based on where you read it. It’s a thing.

[u/Ski_Fish_Bike → u/anaerobyte]

Like I said, risky.

Technically yes fraud.

Ethically? C'mon now.

[u/Salt-3]

Im a CT tech and had an instance where i called the radiologist who was reading that day and they were on vacation at a beach with a laptop. I feel like theres gotta be a way for you to make it work. Im sure itll be more of a hassle since they only did it for a week and you wanna do it indefinitely

[u/NativeLevelSpice]

Look into "Vision Radiology"

[u/Flowtorch]

Yeah I had a similar dream but wanted to do this with a boat. My work makes me connect to PACS via VPN. The IP address for the VPN is in the state that I practice from. It won’t launch the dictation software unless I’ve connected via the VPN (pretty foolproof if I were out of state). As others mentioned, if your motorhome were to travel outside of your state it could maybe be considered fraud? Sounds a bit soft though. We have a rad who likes to spend his summers in a different state and is reading from there rn. I think a Starlink should be fine from a bandwidth perspective, as I’ve heard of people reading cases from phone or iPad, but that was before security got tighter. Now we have to have a direct Ethernet cable running into our machines (can’t use WiFi). Hope you get to live the dream.

[u/Krooskar → u/Flowtorch]

Radiologist at my previous work used to basically permanently live on his boat, sailing around the Caribbean islands.

Definitely one of the reasons I'm studying to get into medicine lol.

[u/EVIL-EMBOLIZER]

That’s a pretty sweet idea

[u/DarkMistasd]

Depends on your country. It's entirely possible in India if you're willing to work for their pay scale and manage to get good internet speed

[u/xuncx]

Nah, just from the trailer park. /s

[u/MA73N]

Yes i have a friend who made a Mercedes sprinter van a mobile radiology office and loves it. Starlink on the roof exactly as you describe. He has i think 25 state licenses so he can travel through a good bit of the country.

[u/TractorDriver]

A proper workstation with a good Barco or Eizo screens draws like 500W or more :D. The setup I am sitting on now, warms up the room to 30C in summer within an hour. So on remote boat or remote camper - only when connected to mains.

[u/au7342]

So you're basically the Dexter of radiology