Radiologists utilize X-rays, MRIs, CT scans, ultrasounds and various other techniques to visualize the body and help diagnose diseases and injuries. Medical transcription companies providing radiology transcription services help them document the results of these radiologic studies or procedures, and produce different types of reports. However, a major reason for litigation against radiologists is the failure to communicate results properly. Radiology Business recently reported on a new analysis by physician-led malpractice insurer the Doctor’s Company which identified misinterpretation of scans, especially computed tomography (CT) scans, as the leading cause of patient injury in diagnostic radiology.
Published the first week of December, the Doctor’s Company’s study covered nearly 600 malpractice claims against diagnostic and interventional radiologists, closed between 2013 and 2018. According to the analysis:
- about 78% of injuries in cases against diagnostic radiologists were the result of image misinterpretation
- In most cases, the injury was an undiagnosed malignancy
- Most of the misinterpretation (about 78%) occurred with CT scans
- “Technical performance” accounted for about 76% of claims against interventional radiologists
- Faulty technical performance included patients suffering poor outcomes from invasive procedures
- While the appropriate procedure was performed correctly in 65% of invasive procedures, the patient was dissatisfied with the outcome
- 11% of claims against interventional radiologists were due to poor technique or treating the wrong site
- 18 percent of injuries are associated with poor communication between physicians
One key takeaway for radiologists is the need to improve information exchange among providers and with patients.
According to study author Darrell Ranum, vice president of patient safety and risk management with the Doctors Company, “The findings on interventional radiology indicate the importance of communication between the radiologist and the patient prior to the surgery or procedure”. It is critical that the radiologist clearly explains the chances for injury during the informed consent process and ensures that the patient understands the risks.
The study recommended several risk mitigating strategies that radiologists can use, such as equipment tracking inspections, monitoring updates and settings, ordering repeat studies if views lack quality, and having a defined process for identifying and analyzing diagnostic errors.
RSNA 2019 has stressed that patient-centered care means that radiology must make reports more digestible for patients (www.healthimaging.com). A study led by Penn Medicine researchers who crowd sourced the question as to whether patients understand radiology reports found that less than half the respondents (patient surrogates) correctly interpreted the reports.
Typically, the reader of the radiology report is the physician responsible for providing direct patient care. The radiology report contains the radiologist’s interpretation, discussion, and conclusions about the radiologic study. The report poses a liability risk if it fails to effectively communicate important information about the patient’s condition. The healthcare provider, who depends upon the report to make decisions concerning patient management, should clearly understand the report. To meet this requirement, the report should be brief, clinically relevant, and consistent. Effective report writing means that pertinent information about the diagnosis, condition, response to therapy, and/or results of a procedure performed, will be transmitted clearly and concisely. Structured reporting is advocated as a means to improving the quality of radiology reports and patient management.
The radiology report also communicates information to patients and their family members. Many healthcare institutions make radiology reports available through patient portals. Radiological screening programs, such as breast screening programs, typically communicate results directly to patients. Experts say that the language used must be comprehensible to patients.
To reduce risk of malpractice suits, radiologists need to ensure accurate, timely, appropriate, and documented communication. Medical transcription outsourcing can help radiologists ensure that there are no mistakes in the reports, including typos and dropped words. To ensure proper evidence, the radiologist’s thought process as well as all consultations and discussions held should be documented. Experts say that radiologists can also minimize risks of misinterpretation by avoiding reading studies and modalities in which they lack proper training and obtaining follow-up consultation with subspecialists (radiologybusiness.com).