What radiologists can learn from reviewing malpractice claims data

Interpretation errors and communication failures are two of the largest issues that lead to malpractice claims in radiology, according to new research published in Diagnosis. Understanding ways to improve in these areas can help specialists “play a vital role in facilitating optimal patient care.”

The authors reviewed data from more than 1,300 medical malpractice claims where radiology was the primary service provider, looking for information on what most often leads to patient harm. The data came from a national database of nearly 400,000 claims.

“Just as radiologic studies allow us to see past the surface to the vulnerable and broken parts of the human body, medical malpractice claims help us see past the surface of medical errors to the deeper vulnerabilities and potentially broken aspects of our healthcare delivery system,” wrote lead author Dana Siegal, RN, CPHRM, CPPS, director of patient safety for Harvard-owned CRICO strategies in Boston, and colleagues. “And just as the insights we gain through radiologic studies provide focus for a treatment plan for healing, so too can the analysis of malpractice claims provide insights to improve the delivery of safe patient care.”

Almost 60 percent of the medical malpractice claims where radiology was the primary service provider were related to “an allegation of diagnostic failure.” Forty-eight percent of these claims included a misinterpretation that delayed patient care.

The authors noted that continued education and peer review are two immediate ways to make an impact in this area. And in some cases, non-radiologists are actually interpreting studies instead of a radiologist. Perhaps, Siegal et al. suggested, non-radiologists should not go unchecked when they make initial interpretations. “It is our goal to improve prompt identification of these important findings by recommending the adoption of comparable review processes whereby a radiologist ‘over-reads’ imaging studies initially interpreted by non-radiologists,” they wrote.

Meanwhile, 23 percent of the claims involved a communication problem, whether it was communication between the radiologist and the ordering provider or communication to the patient. “Despite the fact that our claims analysis cited communication errors less frequently than failures in diagnosis, policy improvement targeting flaws in this process has the ability to produce widespread and measurable change,” the authors wrote. “This can be achieved by implementing clear and well-communicated processes defining the methods and accountability for information transfer between radiologists, clinicians and patients.”

Free access to the full study is available here.