The retail giant Walmart has provided employees who have company health insurance a guide to 800 imaging centers it has identified as providing high-quality care. Walmart employees are not required to use one of those centers should they need radiology exams, but if they don’t use an available diagnostic imaging center from the list that’s near them, they will have to pay a larger share of the full cost.
Why such an emphasis on procedures like CAT scans and MRIs?
Walmart says errors made by imaging centers have led to numerous misdiagnoses, which have in turn led to unnecessary surgery and wasted healthcare spending.
According to a Kaiser Health News report, Walmart officials discovered about half of the company’s workers who went to the Mayo Clinic and other specialized hospitals for back surgery in recent years turned out not to need the operations. “They were either misdiagnosed by their doctor or needed only non-surgical treatment.”
That’s a misdiagnosis rate of about 50 percent, for which the recommended solution is back surgery.
A 2013 study published in the American Journal of Roentgenology says the average real-time error rate in typical radiology examinations is about 3-5 percent. The retrospective error rate among radiologic examinations based on reviews after a diagnosis is made through other means is approximately 30 percent.
As for back surgery, research suggests that 20 to 40 percent of back surgeries are not successful. Back surgery can carry higher risks than some other types of surgery, including paralysis and infections, because it is done closer to the nervous system, says the American Society of Anesthesiologists.
Walmart’s insistence that its employees get high-quality diagnostic imaging care is being heralded as a game-changer.
In recent years, large employers have steered workers to hospitals with proven track records for specific procedures, such as transplants. Walmart is thought to be the first to suggest employees use specific imaging providers based on diagnostic accuracy rather than price, Kaiser Health says.
Covera Health, a New York City-based health analytics company, created the list of imaging centers for Walmart.
“A quality MRI or CT scan can improve the accuracy of diagnoses early in the care journey, helping create the correct treatment plan with the best opportunity for recovery,” Lisa Woods, senior director of benefits design for Walmart, told Kaiser Health. “The goal is to give (employees) the best chance to get better, and that starts with the right diagnosis.”
Common Radiological Imaging Misdiagnosis Errors
Patients who don’t work for Walmart and benefit from its guide apparently will continue to face a 50-50 chance of a missed diagnosis when they get a CT scan, MRI or X-ray for a back problem.
A 2013 study says 75 percent of legal claims against radiologists are based on failure to diagnose a disease or, less commonly, failure to recommend additional testing or to communicate a possible diagnosis to a patient or that patient’s physicians.
The most frequently missed diagnoses are:
- Breast cancer
- Non-spinal fractures
- Spinal (back) fractures
- Lung cancer
- Vascular disease.
How to Avoid Radiological Imaging Errors
Morris Panner, CEO of Ambra Health, a maker of a cloud-based medical image management suite of tools, has proposed Six Ways To Lower Errors – And Unnecessary Surgeries – In Radiology Exams.
Panner’s suggestions include:
- Systematic peer review. There should be continuous, structured and systematic procedures in place so that professionals may evaluate each other’s work performance. “This peer-review process should be built upon a commitment toward diagnostic accuracy and mutual respect,” Panner says.
- Avoiding burnout. Instituting double reads, limiting the length of work shifts, establishing structured breaks, and switching between modalities during the workday can improve productivity and reduce diagnostic errors.
- Supporting decisions with AI. Artificial intelligence and machine learning technology are increasingly able to read and compare large sets of data, which will allow applications to compare and accurately interpret diagnostic images.
- Ensuring consistent follow-up and reporting. A system should be in place to ensure timely follow-up and reporting of imaging recommendations.
- Educating technicians and professionals. Panner recommends “a multi-pronged approach that includes case-based learning, focus on real-world diagnostic decisions (and) putting a premium on the convergence of intuitive and analytical thinking.”
As Panner points out, multiple software solutions and other technology is available to assist with programs to support radiological diagnostics. They can not only provide cost savings upfront but reduce medical errors and the cost of malpractice claims, as well as the pain and loss caused by missed diagnoses.
Managed Care magazine said in March 2019 that an estimated 40,000 to 80,000 hospital deaths each year can be attributed to diagnostic errors and that they cost about $100 billion a year in wasted medical spending.
Further, diagnosis-related errors “are the single largest root cause of medical malpractice claims and result in payouts that are larger than those stemming from the next five highest categories combined.”
How a Medical Malpractice Lawyer in Oklahoma City Can Help
As you can see, diagnostic errors are common. Oklahoma civil law provides a means for patients who have been harmed by a medical provider’s avoidable error to recover compensation for their losses.
This includes errors that lead to an incorrect or missed diagnosis based on a radiology exam, such as an MRI, CAT scan or X-ray. A medical malpractice lawsuit may demand full compensation for your expenses and losses related to injury or death resulting from a missed or delayed medical diagnosis.
If you suspect that you have been harmed by a doctor’s error, the Oklahoma medical malpractice attorneys at Ryan Bisher Ryan & Simons can investigate to determine what really happened to you or your loved one and whether a medical malpractice lawsuit is in order. If so, we can pursue the full compensation on your behalf. A medical malpractice lawsuit can help you get back on your feet financially after an avoidable injury and hold those who have erred accountable.