Dr. Kenneth J. Keller, medical director of Trinity Health's Radiology Department, said the nation's hospitals and mammography centers would be wise to adopt layers of security similar to what Trinity Health has in place in order to protect the integrity of breast cancer screening.
Keller was commenting on the case of a hospital mammographer in Georgia, who was found guilty of falsifying mammogram reports on more than a thousand patients. The worker was bypassing the role of a radiologist and issuing bogus reports that claimed mammograms were normal even though many had abnormalities that turned out to be cancerous.
Keller said such clinical misconduct would be nearly impossible to carry out at Trinity Health, thanks to a system of numerous checks and balances.
"First of all, with our electronic record, every radiologist has a username and password that is unique to that individual, and the passwords are changed frequently," Keller explained. "Secondly, we have separate computerized systems for storing images and reporting findings. The exam is reviewed and dictated in one system and the report is stored in the electronic health record, both of which have separate password protection."
Connie Busch, coordinator of Trinity's Breast Imaging Center, said a third layer of security involves the medical transcription process. "After the radiologist completes the dictation, a transcriptionist turns it into a report and sends it back to the radiologist's Inbox to be reviewed and signed," she said. "To gain access to that report, I would somehow have to figure out the timing of that process. Then I would have to log in as a transcriptionist, which I wouldn't be able to do because our system limits users' access to only those pieces of the record that pertain to them."
Both Keller and Busch noted that a fourth layer of security involves regular audits by the medical director and breast imaging coordinator that scrutinize all abnormal mammograms and reports. Yet a fifth layer is an annual peer review process in which a number of randomly selected screening mammograms are reviewed by a second radiologist to check for quality.
Keller said he felt the need to speak out about the Georgia case for fear it might undermine the confidence women have in their mammography providers.
"If women read that article and start to question whether their own mammogram is safe and whether screening mammography is even worthwhile, then it can jeopardize their own health," Keller said. "I want Trinity patients to have full assurance that this could never happen here."