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  • Unilabs embroiled in Romanian teleradiology scandal

    Posted by john_conklin on February 24, 2023 at 6:22 pm

    So if these were elective outpatient exams why would there be a need for a preliminary interpretation?

    buckeyeguy replied 1 year, 4 months ago 6 Members · 16 Replies
  • 16 Replies
  • Patrick

    Member
    February 24, 2023 at 6:43 pm

    We have colleagues advocating for and using similar arrangements here in the US. Of course, its not ghosting They overread it all. Shady!

    • ruszja

      Member
      February 25, 2023 at 4:56 am

      She is just a really, really fast reader:

      [I]
      Dr. Daria Arif herself produced reports for 108,000 of these cases, including 22,000 reports from MRI exams — mostly knee, back, and head studies — in 2021 alone. That 2021 productivity level corresponds to 94 reports per working day and one every five minutes, the NRK noted.[/I]
      (from the article)

      If it quacks like a duck…..it’s probably a Zebra. This appears to be some kind of ghosting scheme where a husband and wife team trained in Norway, then moved to Romania and set up a practice with romanian rads reading studies for their norwegian clients.
      We have had that in US some years back, was even promoted by MGH. Use wage arbitrage in healthcare. Nice MBA project, I am sure there is a healthy profit in it.

      • buckeyeguy

        Member
        February 25, 2023 at 4:03 pm

        What do they say about importing the 3rd world?
         
        Great work, Norway.

        • Unknown Member

          Deleted User
          February 25, 2023 at 7:45 pm

          Maybe try to be a little less racist next time.

          So, everyone from the third world is a thief?

          • buckeyeguy

            Member
            February 26, 2023 at 5:05 pm

            When did I talk about races? Another example of pin the racist on the donkey – if in doubt, just call people “racist” blindly. Great job.
             
            Are you calling everyone a thief? Weird question, very telling about your stupid world views and inability to read or critically think.

            • Patrick

              Member
              February 26, 2023 at 7:10 pm

              3rd-world aside.  Not sure why race was invoked?  Romania is definitely white-by-American-standards and low-to-middle income.  Norway is probably one of the least-diverse, white-by-American-standards countries on the planet. The accuser is racist in assuming the otherness of a 3rd-world country (Much of post-Soviet East fits in here) and whiteness of the first-world nation (Japan, Singapore, gulf states, etc dont fit the white = wealthy narrative).  As to the organizers, likely white-adjacent, but white-by-American standards.  (Dripping with sarcasm as was my first comment)

              • buckeyeguy

                Member
                February 28, 2023 at 8:38 pm

                The proof that none of these words means anything anymore.
                 
                If only Wakanda were real … oh the irony.
                 
                Oh, I forgot, the Greeks and Egyptians were black. Yeah.

                • Unknown Member

                  Deleted User
                  March 1, 2023 at 10:12 am

                  I wanted to take sometime to think before I posted a response.  Yes, my response was hasty and I made a insulting accusation without thinking it through. Please accept my apology.
                   
                  I have a question for you if you would be kind enough to indulge me. What did you mean by ” What do they say about importing the third world” ? Could you kindly elaborate further?

                  • dwinn5

                    Member
                    March 1, 2023 at 10:37 am

                    Are they mad that a Radiologist created a model using prereaders to make them more efficient, that PHI may have been compromised, or something else… 
                     
                    Only one side to this story- the rad group probably tried to renegotiate their contract and some pencil pusher was pissed. No where does it mention that the rad group was probably forced to read so many exams to keep up with the demands, and just found a way to do it efficiently. 
                     

                    • Patrick

                      Member
                      March 1, 2023 at 7:20 pm

                      If by efficiently, you mean fraudulently? The volumes reported by signers would be enough for this pencil pusher to assume something was going on

                    • dwinn5

                      Member
                      March 2, 2023 at 3:59 am

                      No where in the article does it mention there was a quality problem with any of the reads, they focus more on the countries involved.
                      So they trained a group to act as radiology assistants, but ultimately signed the reports and are taking responsibility for the impression.
                       
                      Would love an explanation as to how that’s any different from using some of the AI tools out there that automatically generate impressions or prereaders to do the same.
                       

                    • Patrick

                      Member
                      March 2, 2023 at 9:36 am

                      TechNerd, this is where you and I are just gonna disagree…  You seem to fall into the camp that accepts such practice, which IMO will be abused and result in ghosting as I suspect happened in this case.  As I read the article, I find the force multiplier effect to be so high that proper overreads by the duly licensed Norwegian radiologists may not have occurred, which is fraud at best, particularly if the patients were unaware.  
                       
                      My comments are not meant to suggest that the training and regulation of foreign radiologists is not good to excellent outside of the US, or Norway. But, I am not a “World is Flat” kind of guy as regards the practice of medicine, and would like to see patients protected by local standards of practice, training, and licensing.
                       
                      As regards the difference, the Romanian radiologists are unlicensed healthcare practitioners in Norway providing services for patients located in Norway.  They are, in fact, practicing medicine, and again, based on numbers, are unlikely to have been properly overseen.  AI is different in that it is deployed as per FDA approved indications and expected to be overseen by a responsible, licensed physician, ideally a radiologist.  Of course, similar to the use of unlicensed foreign medical personnel, there is a slippery slope that will result in inadequate oversight, and this is something we must watch for patients. 
                       
                      I’d whistle blow every day of the week if I found this stuff operating at any facility I oversee.  And, unfortunately, I know there radiologists that are openly advocating and using such arrangements in the US.
                       
                      @ Dream Run, maybe I shouldn’t have defended you…  The Wakanda, Greece, and Egypt references seem racially barbed.

                    • buckeyeguy

                      Member
                      March 3, 2023 at 6:51 pm

                      You should always defend the truth, and it seems you still are.
                       
                      I’m not the one that lies about all this stuff. You can go to your local HR and see all the modern day nonsense, up close and personal
                       
                      You guys act like advanced societies should apologize for creating places where everyone wants to come, thereby demonstrating for better or worse that they are in fact more advanced. The irony is that what made the advanced countries/civilizations great has been ignored for years, if not totally done away with, as their people have been manipulated and debased, so they are turning into the … 3rd world.

                    • aaishafatima999_432

                      Member
                      March 3, 2023 at 7:35 pm

                      [link=https://www.auntminnie.com/index.aspx?sec=sup&sub=pac&pag=dis&ItemID=139394]Unilabs embroiled in Romanian teleradiology scandal[/link][/h1] By [link=https://www.auntminnie.com/index.aspx?sec=ath&sub=bio&pag=disCse&athId=4051]Erik L. Ridley, AuntMinnie.com staff writer[/link]

                      February 23, 2023

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                      The exams included CT, MRI, and x-ray studies, the NRK reported. What’s more, 14 of the clinic’s 16 radiologists listed in Unilabs’ internal systems were not found in the Norwegian healthcare personnel register, the NRK reported in an [link=https://www.nrk.no/rogaland/xl/i-skjul-sender-unilabs-norske-rontgenbilder-til-romania-1.16289933]article[/link] published on February 20. These 14 radiologists, who do not speak Norwegian and were not authorized as healthcare professionals in Norway, examined 53,760 studies of Norwegian patients — a third of the overall studies read for Unilabs over the past six years, according to the NRK.
                      The clinic — Centrul Medical Transilvania (CMT) in Cluj-Napoca, Romania — is owned by Dr. Khaled Arif and Dr. Daria Arif, who had both received Norwegian approval as radiologists in 2004. NRK reported that the married couple had signed 168,000 reports for imaging exams of Norwegian patients over the past six years. Dr. Daria Arif herself produced reports for 108,000 of these cases, including 22,000 reports from MRI exams — mostly knee, back, and head studies — in 2021 alone. That 2021 productivity level corresponds to 94 reports per working day and one every five minutes, the NRK noted.
                      That figure is significantly higher than what would be expected of a Norwegian radiologist, according to the NRK. Bjorn Egil Vikse, specialist director of Unilab client Helse Vest told the broadcaster that Dr. Daria Arif must have had someone support her and do the primary descriptions. In 2018, Unilabs’ chief medical officer said that the company expects its radiologists to read an average of 5.3 MRI exams per hour; Norwegian Unilabs employees who read more than 64 knee MRI exams in the day get a bonus, the NRK reported.
                      Dr. Khaled Arif was said to have personally interpreted 10,500 exams of Norwegian patients, and he must have reexamined and signed over 53,200 studies initially reviewed by Romanian radiologists who did not have Norwegian authorization, according to the NRK.
                      In response to NRK’s reporting, Unilabs Norway CEO Baber Qazi said that Daria Arif interpreted more than 100,000 exams without help. He also stated that the remote interpretations can’t be compared with investigations carried out in the hospital, as hospital exams are often more complex. Unilabs has implemented a number of workflow improvement measures, he told the NRK.
                      As for the exams interpreted by the Romanian radiologists without licenses in Norway, Qazi said that those were preliminary investigations that were also reexamined, described, and signed by the Arifs.
                      None of the Norwegian health authorities contacted by the NRK were aware of the Unilabs partnership with the Romanian clinic.
                      A subsequent NRK [link=https://www.nrk.no/rogaland/unilabs-avslutter-omstridt-romania-avtale-etter-nrk-avsloring-1.16306476]article[/link] on February 22 reported that Unilabs has now decided to end the partnership with the Romanian clinic. The company elected to do this because it takes it “very seriously that questions are raised about the quality of the services we offer and whether patient safety is safeguarded in line with Norwegian law,” Qazi told the NRK.
                      Qazi also told the news outlet that “no errors or deficiencies have been discovered in the interpretations and descriptions from Romania.”
                       

                    • aaishafatima999_432

                      Member
                      March 3, 2023 at 7:36 pm

                      ‘These 14 radiologists, who do not speak Norwegian and were not authorized as healthcare professionals in Norway, examined 53,760 studies of Norwegian patients — a third of the overall studies read for Unilabs over the past six years, according to the NRK.’
                      Reading the history without knowing the language. 

                    • buckeyeguy

                      Member
                      March 5, 2023 at 7:46 pm

                      Baber Qazi Ruth hit a home run … until he got busted.