Hospitals outsource radiology servicesSFlb

NightHawk services more than 1,500 hospitals in the U.S. after hours.

Scripps Howard

A person suffering an apparent stroke is rushed to a hospital in Ventura County, Calif. sometime after 7 p.m. Almost instantly, e-mailed images of the patient’s brain emerge on Dr. James Brull’s computer in Hays, Kan.

Brull is a nighthawk — one of a growing group of specialists who read complicated X-rays, MRIs and CAT scans at night from hospitals that might be located nearby or hundreds of miles away. Brull, who has staff credentials at about 1,000 hospitals across the nation, studies the images on four computer monitors then dictates a preliminary diagnosis that is transmitted back to Ventura County.

And it all happens within an average of 20 minutes.

As part of a reliance on distance medicine and technology spreading throughout the health-care industry, radiology groups from at least six hospitals in Ventura County outsource their night coverage. When a patient shows up in the emergency room after hours, his or her scans likely will be transmitted off-site — as nearby as Alhambra in the San Gabriel Valley or, in Brull’s case, to a remote Kansas town once roamed by Wild Bill Hickok and George Armstrong Custer.

“Literally, I can be almost anywhere and be working for NightHawk Services,” Brull said in a phone interview from his car after a stint reading images from Milwaukee.

Radiology groups for at least five hospitals in Ventura County use NightHawk, a company in Coeur d’Alene, Idaho, that serves about 1,500 hospitals nationwide. NightHawk sends images to 120 board-certified radiologists across the country as well as in Sydney, Australia, and Zurich, Switzerland.

Although Brull occasionally works on images sent from Community Memorial Hospital in Ventura, radiologists from that hospital and several others in the county said the bulk of their night work is sent to nighthawks in Southern California, and all of it remains in the United States. They said the service means patients receive quicker treatment and have access to radiology specialists all hours of the night.

Radiologists and hospital officials said the program relieves pressure on doctors who already work long hours.

“We wanted to keep our doctors rested and clear,” said Dr. Stanley Frochtzwajg, chief medical officer at Community Memorial Hospital. “If they don’t have to stay up all night, they’ll perform much better.”

As technology has increased, so has the use of computerized scans that can detect spinal injuries, complicated fractures, head trauma, heart problems, blood clots and other abnormalities. Dr. Charles North, a senior radiologist based at Community Memorial, said an emergency room might see 10 to 20 radiology cases a night, and each can include hundreds of images.

Hospitals and radiology groups either have to ask their staffs to work marathon hours, hire more hospital-based radiologists or find nighthawks.

“It’s cheaper to contract it out,” said Jim Lott of the Hospital Association of Southern California, and it helps patients.

Medical experts say the lack of direct contact with a patient isn’t important, because everything the radiologist needs for a preliminary diagnosis is contained in the computerized scan or X-ray. They note that even hospital-based radiologists don’t typically interact with patients when reading their images.