NightHawk takes aim at RadPeer with its own interpretation QA program

NightHawk Radiology Services announced its entry into the imaging interpretation quality assurance business at a scientific session Thursday at the ECR, arguing that it offers a more rigorous and objective system for evaluating the quality of radiologists’ work.

Although Europe is not its primary market for the service, NightHawk chief medical officer Dr. Timothy V. Meyers said the international exposure wouldn’t hurt the company. The primary market, he said after the session, is the U.S. and NightHawk has already started offering the service to some radiology practices. Further, although he did not mention it in the talk, NightHawk is hoping to carve away some of the quality assurance work now held by the ACR under its RadPeer program.

The title of the talk was “Beyond RadPeer: The next generation of quality assurance.”

Meyers described the NightHawk program and its experience in evaluating more than 2.1 million cases between May 1 and Dec. 31 of last year. A fraction of those cases (1.86%) were returned with discrepancy reports identified by the radiologists who performed final reads on preliminary reads provided by NightHawk radiologists.

“The Achilles heel of any (quality assurance program) is the underreporting of discrepancies,” Meyers said.

A program based on objective patient outcomes will result in fewer underreporting errors and a system that more accurately and objectively rates radiologists will be more easily accepted, he said.

The study broke the discrepancies into four categories and focused on two that were most likely to affect patient management. There were 5338 in those two categories (out of a total 38,623). A further review found that 2468 were valid, Meyer said.

Under questioning from a member of the audience, Meyers acknowledged that the program can’t assure that it is catching all discrepancies, since the actual reporting rate was only 1.86%, but he said NightHawk is making an effort to strengthen communications and reporting by radiologists who provide the final interpretations and discrepancy reports.

The company bases its evaluation on both the accuracy of the report and the quality, considering factors such as pertinence, clarity, and appropriate brevity. Data are collected by the radiologist who originates the report. Secondary reviews are carried out by an internal review board, the medical director, and the chief medical officer.

Standards at all levels are clear and avoid the ambiguity that can plague other systems, Meyer said.

“Avoiding subjective judgments decreases the insinuation of guilt associated with a misinterpretation,” he said. “This leads to better acceptance and an easier transition to a (quality improvement program) where collegial follow-up can occur.”