NYC Health and Hospitals Corporation and Columbia University Medical School Address Backlog of Echocardiograms at Harlem Hospital
May 25, 2010
The New York City Health and Hospital Corporation (HHC) and the Columbia University medical school — the physician services affiliate that employs and supervises all doctors at Harlem Hospital Center — today communicated the results of a week-long operation to eliminate a backlog of nearly 4,000 echocardiograms.
On Thursday, 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. As soon as HHC was informed, HHC officials worked with Columbia to immediately put together a team of cardiologists who began reading all outstanding echocardiograms on Friday, May 21st. As of Tuesday, May 25th, more than 1,500 echocardiograms had been reviewed, and no patients were found to be in need of additional follow up care. 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 immediately.
Up until last week, the physicians of the cardiology service at Harlem Hospital had prioritized the review of echocardiograms identified as abnormal by trained technicians. 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.
“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.”
“We are committed to working with HHC to address this inexplicable situation and to providing the highest level of care to patients at Harlem Hospital,” said Columbia Dean of the Faculties of Health Science and of Medicine Lee Goldman.
“An echocardiogram is a test that uses ultrasound to evaluate heart muscle and valve functions. It is required to be analyzed by physicians credentialed in echo cardiology. Approximately 2,500 echocardiograms are done at Harlem Hospital each year. To prevent a situation like this from occurring in the future, HHC and Columbia have revised the hospital practices and will ensure that all echocardiograms are reviewed and reported to the appropriate physician within two working days. Additionally, the 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.”
HHC has already reported this situation to the State Department of Health and is conducting a full investigation. HHC also conducted a sample audit of echocardiogram tests at all its other hospital facilities and confirmed that this is an isolated situation.
While the investigation is ongoing, HHC President 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. This matter was also reported to the New York State Office of Professional Medical Conduct for further investigation and HHC will lend its full cooperation to such investigation. Other disciplinary action may be taken when results of the investigation are complete.
Harlem Hospital will also reach out to all patients whose echocardiograms were not read in a timely manner regardless of their need for follow up to explain the delay and confirm their test results. Harlem Hospital has also set up a 24-hour hotline to assist patients who have received an echocardiogram and want to either learn or confirm their test results. New Yorkers interested in learning more should call 311.
Contact: Ian Michaels (HHC) (212) 788-3339