Hospitals are outsourcing radiology work

[OhioChick]

Friday, October 17, 2008

A person suffering an apparent stroke is rushed to a hospital in Ventura County sometime after 7 p.m. Almost instantly, e-mailed images of the patient's brain emerge on Dr. James Brull's computer in Hays, Kan.

Brull is a nighthawk — one of a growing group of specialists who read complicated X-rays, MRI and CAT scans at night from hospitals that might be located nearby or hundreds of miles away. Brull, who has staff credentials at about 1,000 hospitals across the nation, studies the images on four computer monitors then dictates a preliminary diagnosis that is transmitted back to Ventura.

And it all happens within an average of 20 minutes.

As part of a reliance on distance medicine and technology spreading throughout the healthcare industry, radiology groups from at least six hospitals in Ventura County outsource their night coverage. When a patient shows up in the emergency room after-hours, his or her scans likely will be transmitted off-site — as nearby as Alhambra in the San Gabriel Valley or, in Brull's case, to a remote Kansas town once roamed by Wild Bill Hickok and George Armstrong Custer.

"Literally, I can be almost anywhere and be working for NightHawk Services," Brull said in a phone interview from his car after a stint reading images in Milwaukee.

Radiology groups for at least five hospitals in Ventura County use NightHawk, a company in Coeur d'Alene, Idaho, that serves about 1,500 hospitals nationwide. NightHawk sends images to 120 board-certified radiologists across the country as well as in Sydney, Australia, and Zurich, Switzerland.

Quicker treatment received.

Although Brull occasionally works on images sent from Community Memorial Hospital in Ventura, radiologists from that hospital and several others in the county said the bulk of their night work is sent to nighthawks in Southern California, and all of it remains in the United States. They said the service means patients receive quicker treatment and have access to radiology specialists all hours of the night.

http://www.venturacountystar.com/news/2008/oct/17/long-distance-healthcare-quotits-unrealistic-for/

[DangerDave921]

1. Very common nowadays

I do medical malpractice work as an attorney and this is a very common practice. Many hospitals don't even employ radiologists. They contract out the services to a radiology practice.

The technology today is amazing. These computer images are so good. And it really doesn't matter if you're in the hospital or 100 miles away EXCEPT for the lack of face-to-face communication between the radiologist and the treating doctor. There are some films that need a joint collaboration to decide on what's going on.

[blue97keet]

3. If something is screwed up then nobody is responsible?

Kinda like securitizing mortgages?

[DangerDave921]

4. what do you mean?

I'm not sure I get your point. If the radiologist who reads the film is negligent, then yes he can be found negligent. Just like if he was in the hospital reading the film. Just because he's not on-site doesn't mean he can't be found negligent.

[OhioChick]

5. Good question...

Would the hospital be held liable for medical malpractice, or the radiologist? Also....do the same medical malpractice laws apply in other countries as they do here....and to what degree? (Limitations, etc.)

[DangerDave921]

9. excellent question

I've had numerous cases where radiologists are not employees of the hospital, but are still on-site. I've never had one where the radiologist is in another country. That would be really interesting. If the radiologist does his act of negligence in another state, you would simply have to file suit against that doctor in his home-state.

Also, a hospital can be liable under a theory of agency for the acts of its workers, even if they are not actual employees but are instead independent contractors. In other words, if the radiologist is engaged in furthering the business interests of the hospital, then the radiologist
can be construed as the hospital's agent sufficient to make the hospital liable.

[OhioChick]

10. Thanks for your thoughts....

I've always wondered how a medical malpractice case with these circumstances would play out.

We could've used your services within our family on several occasions. Much malpractice out there, unfortunately and it's difficult to pursue.

[DangerDave921]

11. it is expensive

Which restricts the number of cases our firm can take on. Sadly this is a business too. It is very costly to hire experts, take depositions, etc. But I agree there is a ton of malpractice out there, most of which goes unnoticed.

Sorry your family had problems.

[Azlady]

2. Yep....

Happening in my area and lots of radiology jobs are gone, but at this organization is keeping jobs here in the country, verses going off shore.
Geez

[quidam56]

6. If something is screwed up no one is responsible because..

Hospitals never make mistakes it's called "acceptable standards of health care". ---> http://www.wisecountyissues.com

[DangerDave921]

7. what are you talking about

I am a medical malpractice attorney. Believe me, hospitals pay millions and millions of dollars in settlement and jury verdicts for the mistakes of their employees.

[OhioChick]

8. Since you're a Med. Mal. lawyer...

Can you answer my questions in post 5?