List date(s) this work was published or aired.
Nov-11
Provide a brief synopsis of the story or stories, including any significant findings.
Self investigates the growing practice of teleradiology, in which radiologists– working remotely and often in different time zones– read the scans of patients thousands of miles away. While the practice has allowed small, often understaffed hospitals to provide radiology around the clock, Self found that the practice can open the door to confusion, errors and outright fraud: The person reading your scan may not be a doctor, or in the worst-case scenario, may not be any one at all.
Major Findings:
– Radiologists who interpret scans remotely rarely receive or understand the context of a patient’s ailment, which can be crucial to an accurate diagnosis. They also rarely discuss their findings with the treating physicians, thereby increasing the chances of confusion, error and missed diagnoses.
– The outsourcing and remote reading of scans allows for a fraudulent practice called “ghosting,” in which doctors sign off on scans they haven’t read. This problem– though difficult to measure– is more prevalent than previously thought.
– Hospitals that outsource their scans often do little quality control to ensure the accuracy of the remote readings.
Explain types of documents, data or Internet resources used. Were FOI or public records act requests required? How did this affect the work?
The article required extensive use of court records, often in cases with confidential settlements where those involved could not discuss the events. To reconstruct the case of Jennifer Drumm, for example, all Self knew was an attorney’s name and the state in which he was licensed. It took extensive online research, in PACER and LEXIS court records, as well as telephone reporting to courthouses around Pennsylvania, to actually find the case. Self then reconstructed the events entirely through thousands of pages of court records, including motions, depositions and reports by experts. The case of Dr. Reddy, as well as the events in Perry, Georgia, were also largely reconstructed through court records.
Explain types of human sources used.
Self conducted extensive interviews with radiologists, technicians, plaintiff lawyers and medical ethicists, and wherever possible, with patients.
Results:
There has been little written, previously, in the mainstream press about the problems with teleradiology. To date, Eban has been contacted by numerous radiologists eager to share their experiences of the dangers they’ve seen, including the widespread solicitation of teleradiologists by companies in India, offering to cheaply ghost-read their scans.
Follow-up (if any). Have you run a correction or clarification on the report or has anyone come forward to challenge its accuracy? If so, please explain.
No, there has been no challenge to the story’s accuracy and no correction or clarification has been needed.
Advice to other journalists planning a similar story or project.
It’s a hard slog. There is almost no data that captures errors resulting from teleradiology, or even the prevalence of teleradiology itself. As well, the patient cases are deeply buried and often muzzled by confidentiality agreements. The places to turn are: the American College of Radiology; any local or national organizations of plaintiff lawyers; and state medical boards.