a night. Because ER physicians are not trained to read CT scans or MRIs, radiologists went from working 8–10 hours a day, five and half days a week to a schedule of 24 hours a day, 7 days a week coverage. This became a particularly acute challenge in smaller rural facilities that only had one solo radiologist with no other to share call. These circumstances spawned a post-dot.com boom of firms and groups that provided medical outsourcing, off-site teleradiology on-call services to hospitals and Radiology Groups around the country. As an example, a teleradiology firm might cover trauma at a hospital in Indiana with doctors based in Texas. Some firms even used overseas doctors in locations like Australia and India. Nighthawk, founded by Paul Berger, was the first to station U.S. licensed radiologists overseas (initially Australia and later Switzerland) to maximize the time zone difference to provide nightcall in U.S. hospitals. Currently, teleradiology firms are facing pricing pressures. Industry consolidation is likely as there are more than 500 of these firms, large and small, throughout the United States. Nonprofit Although teleradiology is flourishing in the developed world, few teleradiological links have been made to the developing world. Generally, barriers to the implementation of radiology services have also complicated setting up reliable links. Several examples of simple, low-cost nonprofit teleradiology solutions have been employed by Satellife and the Swinfen Charitable Trust. Established in 1987 by Nobel Peace Prize laureate, Bernard Lown, Satellife (Boston) was the first non-profit organization to own and use a low earth-orbit satellite as well as mobile computing devices such as handheld computers and mobile phones for medical data communication. Starting in 1998, Swinfen Charitable Trust, a U.K. based nonprofit organization founded by Lord and Lady Swinfen, gave healthcare personnel in remote places internet access and a digital camera, and also facilitated a low-cost telemedicine service linking doctors at hospitals in the developing world with medical and surgical consultants who gave advice at no cost. More complex solutions emerged in 2007. Operated by volunteer radiologists, Téléradiologie sans Frontières (Teleradiology without Borders), a Luxembourg-based nonprofit organization founded by Dr Jean-Baptiste Niedercorn and Dr Gérald Wajnapel, started to provide teleradiology imaging services to developing countries using a professional cloud picture archiving and communications system (PACS). Today, many established private teleradiology practices such as Virtual Radiologic (vRad) are also involved in pilot programs with NGOs, reporting radiographs from rural health centres,