N.Y. cards scramble to review 4,000 unread echos at Harlem Hospital

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Vivid E9 echocardiogram
Image source: GE Healthcare

The Health and Hospital Corporation (HHC), New York City’s public healthcare system, and Columbia University Medical School in New York City, which is the physician services affiliate that employs and supervises doctors at Harlem Hospital Center, Tuesday revealed that they are working to review a backlog of nearly 4,000 echocardiograms that accumulated at Harlem Hospital.

On May 20, officials of Columbia’s affiliation office at Harlem Hospital informed HHC of a backlog of nearly 4,000 echocardiogram tests performed over the past three years that had not been reviewed by cardiologists. Columbia medical school officials identified the backlog as part of a routine review of patient records.

After learning about the unread tests, HHC said its officials worked with Columbia to put together a team of cardiologists who began reading all outstanding echocardiograms on May 21. As of May 25, more than 1,500 echocardiograms had been reviewed, and no patients were found to be in need of additional follow-up care, HHC and Columbia reported.

“If any patient is identified to be in need of follow-up care as the rest of the echocardiograms are read, they will be notified,” the organizations said.

Up until last week, the physicians of the cardiology service at Harlem Hospital had prioritized the review of echocardiograms identified as abnormal by technologists. “Although this process helped avoid a significant number of abnormal echocardiograms in the backlog at Harlem Hospital, this type of reliance on technicians to screen for selective readings was inappropriate,” HHC and Columbia said.

“While the process the doctors followed may have alerted cardiologists to those echocardiograms that were most likely to be abnormal, the failure to read echocardiograms in a timely manner is inexcusable and may have placed patients at risk,” said HHC President Alan D. Aviles. “As our team of cardiologists continues to review every pending echocardiogram, we will take immediate action to locate any patient that may be in need of follow-up care.”

Approximately 2,500 echo studies are completed at Harlem Hospital annually. To prevent a similar situation in the future, HHC and Columbia said they will revise the hospital practices and ensure that all echocardiograms are reviewed and reported to the appropriate physician within two working days. Additionally, the organizations said that number of unread echocardiograms will be reviewed by the hospital medical director on a monthly basis and reported to the Quality Assurance Committee of HHC’s board of directors on a quarterly basis.

While the investigation is ongoing, Aviles has made several staffing changes based on the results of the preliminary findings. The clinical director of the Harlem Hospital department of medicine, who serves as a physician manager under HHC’s affiliation contract with Columbia, has been removed from his duties at Harlem Hospital. Harlem Hospital’s medical director, who had general oversight responsibility for the quality of clinical care, has been demoted.

The organizations said that the matter also was reported to the N.Y. Office of Professional Medical Conduct for further investigation. Other disciplinary action may be taken when results of the investigation are complete.