Healthcare service line experts are warning about the perils of outsourcing radiology care, believing the decision could potentially pose “tangible harm” to patients and hospitals.
Demand for faster imaging interpretation has helped propel an uptick in outsourcing, with half of radiologists reportedly reading scans offsite. Based on a recent literature review, researchers are alerting hospitals about some of the most commonly outsourced services, according to a new review published Aug. 16 in Mayo Clinic Proceedings.
“Outsourcing in healthcare is quickly expanding from nonclinical services to include patient-facing clinical service specialties such as anesthesiology, emergency medicine, hospitalist medicine, radiology, neurological monitoring, and others,” Leonard Berry, PhD, MBA, a Texas A&M University business school researcher who studies service quality within healthcare systems, and co-authors advised. “Aside from the high risks of loss of control over clinical quality — and from errors and potential harm to patients — outsourcing may not provide the anticipated financial benefits over time, especially when discounted pricing is used to secure an outsourcing contract with the intention to raise prices later.”
For their study, Berry et. al analyzed published research on the benefits of contracting-out image interpretation and other services. Their work focused on radiology, along with lab work, environmental services and emergency care. They labeled the outsourcing of diagnostic imaging service lines as a medium- to high-risk endeavor, while viewing other care segments such as surgery and cardiology as most risky.
Berry and co-authors acknowledged the importance of using teleradiology to cover care in rural areas but cautioned against other scenarios.
“For these smaller organizations, effective use of teleradiology is a sensible application of outsourcing that can provide access to expert radiological interpretation; reduce patients’ length of stay, rehospitalizations, and transfers to other facilities; and lower the costs of capital and labor,” they wrote, adding that while outsourcing image interpretation is OK, farming out procedures that require in-person radiologist involvement is not.
The European Society of Radiology believes specialists provide greater value when they’re available for direct consultations with referrers. They also hold that poor communication can compromise the safety of care. Authors warned that docs employed by hospitals that use teleradiology may place less trust in the accuracy of outsourced reports, potentially causing physicians to spend more time scrutinizing findings, thereby eroding savings from outsourcing.
“Such reservations about quality are understandable, as it is challenging to maintain quality standards and accountability for outsourced work,” the study stated.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.