Q&A: Jahni Tapley on Saving Lives and Bucking Trends in Rural Oklahoma

For small rural hospitals such as McCurtain Memorial Hospital in Idabel, Okla., an on-staff radiologist is a luxury. After losing its single in-house radiologist, the facility floated between several different teleradiology providers before finally landing on vRad—largely due to vRad’s strong breast health portfolio.

McCurtain County has one of the highest death rates from late-stage breast cancer in the country, according to an analysis by Susan G. Komen.

“When you look at our little county of 36,000 people, you think; ‘How can that be possible?’” says McCurtain Hospital CEO Jahni Tapley. “But then you look around and you can name five people off the top of your head who have breast cancer.”

A combination of low funding and remote location had held back the breast imaging program at McCurtain, Tapley explains. However, the partnership with vRad has been extraordinarily well-received among doctors and patients alike—particularly vRad’s Live Video Diagnostic mammography service.

What are some of the challenges the breast imaging program at McCurtain Memorial Hospital has faced over the years?

Jahni Tapley: We’ve had breast imaging services here for about 20 years, but it’s never been one of our high-volume departments. Part of this was that our equipment was never updated: we are a rural hospital, so we haven’t always had access to good technology.

In addition, a lot of the people here are uninsured and they don’t think about things like mammograms. For the longest time a mammogram was a luxury, not a necessity—and we didn’t have the ability to advertise and get the word out about how important mammograms are.

The hospital now partners with vRad for these services. How has this collaboration impacted your community?

It’s had a huge impact on the community. We are seeing more patients coming in because they’ve heard about Live Video Diagnostics, and physicians have seen quick responses from the vRad radiologists. Not an email, not a chat message, but actually picking up the phone and calling our physicians with the results of exams. We’re seeing this across all services, not just in mammography.

The quick turnaround time also has generated goodwill for us among patients. We’ve had patients drive over an hour to have their images done here. Even though it’s on older equipment, they come here because of the timely readings—we’ve been able to get the word out.

Can you describe the Live Video Diagnostic technology and how it improves the patient experience?

It’s mind blowing, honestly. It’s had a huge impact on patient care in our radiology department and throughout the hospital—the most of any technology in recent years.

Being as rural as we are, anytime things are sent out here, we’re used to waiting. With Live Video Diagnostics, patients can have a face-to-face conversation with the radiologist immediately following the mammogram. We’ve had patients diagnosed with breast cancer over Live Video Diagnostics who left crying, but thanking us. They tell us, “Thank you for not making me hear this over the phone or in a letter. Thank you for letting me have time with this radiologist.”

The radiologists have been phenomenal as well. They talk with the patient about what to expect and what’s next in treatment. They have an incredible ability to comfort these men and women on what is undoubtedly one of the scariest days of their life.

This is a huge improvement over our previous system, where patients would get a phone call saying, “You have breast cancer, you need to make an appointment to see an oncologist.” Oftentimes the closest oncologist is an hour away, and many of our patients work at jobs where you can’t always take off work. It sounds silly when you’re facing cancer, but so many of them work at jobs where, if you miss a day, you’re gone.

Were you surprised at just how big of an impact Live Video Diagnostics had on patient care?

I was very surprised. A lot of times in healthcare, a product or service is hyped up and it doesn’t deliver, but Live Video Diagnostics exceeded our expectations in a way we could have never imagined. That’s not only due to the technology, but because of the radiologists as well. They specialize in mammography, they’re kind and caring, and even though they may be in New York and we’re in rural Oklahoma, they’ve never been condescending or hurried. If they were physically here, it feels like they would be holding our patients’ hands.

What prompted you to partner with vRad?

In the past, we’ve used a variety of setups: radiologist on site, two radiologists splitting shifts, or other teleradiology companies.

When we found ourselves in the position of reorganizing our radiology services, we were looking for affordable, quality service. Quality care is our No. 1 concern, but at some point, you have to be able to afford it as well. We had worked with vRad on weekends and after hour reads in the past, and felt their cost and business models were great for our hospital. When we partnered with them full time, our turnaround times got even better.

What’s next for McCurtain Memorial?

Through a grant, we were able to purchase a high definition breast tomosynthesis scanner. This combined with Live Video Diagnostics gives us the best breast health technology in the state of Oklahoma, and puts us up there with the best breast imaging technology in the country.

That’s not something we thought was possible here in McCurtain County. In fact, the first day the machine was installed, it was booked up through August—we had doctor’s offices telling us they were getting five calls an hour about booking mammograms on the new scanner.

Our goal is to become an accredited breast center. We’ll be the only one in the region. We want to lower the high mortality rate, which goes hand in hand with our partnership with vRad and Live Video Diagnostics. It’s been explosive in the best way possible—it was driven by a desire to talk about breast cancer detection and mammography utilization. We’ve seen too many lives stolen from us because they didn’t get a mammogram in time.

As a Senior Writer for TriMed Media Group, Will covers radiology practice improvement, policy, and finance. He lives in Chicago and holds a bachelor’s degree in Life Science Communication and Global Health from the University of Wisconsin-Madison. He previously worked as a media specialist for the UW School of Medicine and Public Health. Outside of work you might see him at one of the many live music venues in Chicago or walking his dog Holly around Lakeview.

Around the web

The patient, who was being cared for in the ICU, was not accompanied or monitored by nursing staff during his exam, despite being sedated.

The nuclear imaging isotope shortage of molybdenum-99 may be over now that the sidelined reactor is restarting. ASNC's president says PET and new SPECT technologies helped cardiac imaging labs better weather the storm.

CMS has more than doubled the CCTA payment rate from $175 to $357.13. The move, expected to have a significant impact on the utilization of cardiac CT, received immediate praise from imaging specialists.