Healthcare News & Insights

The case of the unread ECHOs: Lessons for docs and patients

The recent disclosure that more than 7,000 ECHOs were never read by a physician has folks up in arms — but not for the reason you’d probably expect.

Over a five-year period, Harlem Hospital Center in New York had some 7,000 echocardiograms that were only read by technicians — the ordering physicians never saw them, for reasons that aren’t clear.

Pretty scary sounding. But follow-up examination of the records found that of the 7,000 ECHOs, only 14 of them had been misdiagnosed. Twelve of those 14 patients were contacted — and none of them had suffered any adverse effects.

That silver lining is disguising a nasty gray cloud. Delving further into that data indicates something doesn’t add up.

To be so accurate in diagnosing via the tests (99.8% accurate, to be exact), the hospital would have to have the world’s best team of technicians — and one wonders why the physician oversight would be needed.

It would also seem safe to assume the doctors ordered those tests for a reason — yet they clearly didn’t use the results when deciding on a course of treatment for their patients. Why not? And why didn’t anyone notice that vital test results were missing?

For that matter, with so many patients seemingly unaffected by their ECHOs never being read, it’s fair to ask how many of those patients actually needed the test performed in the first place.

Without more information, it’s hard to come up with acceptable answers: Perhaps most of the patients were retested later. Possibly more patients were negatively affected than has been disclosed. It’s also possible that this group of ECHOs was not representative of the majority of tests. (Physicians and techs may have given lowest priority to results which showed no indication of disease — and these are the tests that fell through the cracks in the system.)

Regardless, this case has served to shine a light on some of the less visible signs that something has gone wrong with the health care system. Do you blame it on overworked/distracted employees, defensive medicine run amok or something else? Let’s hear your thoughts in the comments.

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