A new study in Radiology comes to an explosive conclusion: medical malpractice cases involving teleradiology interpretation of medical images more frequently involved patient death and had higher payment amounts.
Perhaps no technology has wrought greater changes on the field of medical imaging than teleradiology.
- By leveraging radiology’s conversion to digital imaging and the rapid expansion of Internet bandwidth, teleradiology makes it possible for medical images to be interpreted independent of the radiologist’s location, with studies sometimes literally sent around the world.
But teleradiology has had its share of unintended consequences, such as the emergence of nighthawk and specialty teleradiology firms that have seized hospital contracts from traditional radiology groups.
- What’s more, allegations have occasionally surfaced accusing some telerad firms of “ghosting” (when images read overseas aren’t adequately supervised by US-licensed radiologists).
But this week’s study in Radiology adds a new wrinkle, suggesting that teleradiology could actually have an additional malpractice risk. Researchers analyzed 3,609 malpractice claims, of which 135 involved teleradiology, finding that teleradiology cases…
- Saw patient death occur more often (36% vs. 20%)
- More frequently saw communication problems among providers (26% vs. 13%)
- More often closed with indemnity payments (59% vs. 41%)
- Had higher median indemnity payments ($339k vs. $214k)
Why might problems be more frequent in teleradiology? The authors offered several reasons, including …
- Teleradiologists may not have access to EMR and other patient data
- Teleradiology interpretations are often provided at night and on weekends/holidays
- Claims involving neurology and the emergency setting were more common, illustrating the challenges in these areas
Potential solutions could involve making sure that teleradiologists have access to EMR data, and by performing overreads of interpretations delivered on nights and weekends.
The Takeaway
The findings have disturbing implications, not only for dedicated teleradiology providers but also for traditional radiology practices that use teleradiology as part of their service offerings. And as noted in an accompanying editorial, they could provide ammunition to teleradiology’s opponents, who continue to rail against the technology that has done so much to change radiology.
