Background

The increasing use of teleradiology has been accompanied by concerns relating to risk management and patient safety.

Purpose

To compare characteristics of teleradiology and nonteleradiology radiology malpractice cases and identify contributing factors underlying these cases.

Materials and Methods

In this retrospective analysis, a national database of medical malpractice cases was queried to identify cases involving telemedicine that closed between January 2010 and March 2022. Teleradiology malpractice cases were identified based on manual review of cases in which telemedicine was coded as one of the contributing factors. These cases were compared with nonteleradiology cases that closed during the same time period in which radiology had been determined to be the primary responsible clinical service. Claimant, clinical, and financial characteristics of the cases were recorded, and continuous or categorical data were compared using the Wilcoxon rank-sum test or Fisher exact test, respectively.

Results

This study included 135 teleradiology and 3474 radiology malpractices cases. The death of a patient occurred more frequently in teleradiology cases (48 of 135 [35.6%]) than in radiology cases (685 of 3474 [19.7%]; P < .001). Cerebrovascular disease was a more common final diagnosis in the teleradiology cases (13 of 135 [9.6%]) compared with the radiology cases (124 of 3474 [3.6%]; P = .002). Problems with communication among providers was a more frequent contributing factor in the teleradiology cases (35 of 135 [25.9%]) than in the radiology cases (439 of 3474 [12.6%]; P < .001). Teleradiology cases were more likely to close with indemnity payment (79 of 135 [58.5%]) than the radiology cases (1416 of 3474 [40.8%]; P < .001) and had a higher median indemnity payment than the radiology cases ($339 230 [IQR, $120 790–$731 615] vs $214 063 [IQR, $66 620–$585 424]; P = .01).

Conclusion

Compared with radiology cases, teleradiology cases had higher clinical and financial severity and were more likely to involve issues with communication.

© RSNA, 2024

See also the editorial by Mezrich in this issue.

中文翻译：

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远程放射医疗事故案件的索赔人、临床和财务特征评估

 背景

远程放射学的使用日益增多，也伴随着对风险管理和患者安全的担忧。

 目的

比较远程放射学和非远程放射学放射科医疗事故案件的特征，并确定这些案件背后的影响因素。

 材料和方法

在这项回顾性分析中，查询了国家医疗事故案例数据库，以识别 2010 年 1 月至 2022 年 3 月期间结束的涉及远程医疗的案例。远程放射科医疗事故案例是根据对远程医疗被编码为促成因素之一的案例的手动审查而确定的。 。将这些病例与同期结案的非远程放射学病例进行比较，其中放射科被确定为主要负责的临床服务。记录案件的索赔人、临床和财务特征，并分别使用 Wilcoxon 秩和检验或 Fisher 精确检验比较连续数据或分类数据。

 结果

这项研究包括 135 例远程放射学病例和 3474 例放射学事故病例。远程放射学病例（135 例中的 48 例 [35.6%]）患者死亡发生率高于放射学病例（3474 例中的 685 例 [19.7%]； P < .001）。与放射学病例（3474 例中的 124 例 [3.6%]； P = .002）相比，远程放射学病例（135 例中的 13 例 [9.6%]）中脑血管疾病是更常见的最终诊断。在远程放射学病例（135 例中的 35 例 [25.9%]）中，提供者之间的沟通问题比放射学病例（3474 例中的 439 例 [12.6%]； P < .001）更常见。远程放射学案件比放射学案件（3474 起中的 1416 起 [40.8%]； P < .001）更有可能以赔偿金结束（135 起中的 79 起 [58.5%]），并且赔偿金中位数高于放射学案件（ $339 230 [IQR，$120 790–$731 615] vs $214 063 [IQR，$66 620–$585 424] P = .01)；

 结论

与放射学病例相比，远程放射学病例具有更高的临床和财务严重性，并且更有可能涉及沟通问题。

 © 北美放射学会，2024

另请参阅本期 Mezrich 的社论。