Review of Veterans Health Administration’s National Teleradiology Program

The VA Office of Inspector General (OIG) conducted a healthcare inspection of the Veterans Health Administration (VHA) National Teleradiology Program (NTP) to assess allegations that an NTP radiologist (radiologist) misread a patient’s imaging study and NTP delays reporting interpretation results at multiple facilities. The OIG evaluated NTP’s oversight of radiologists, timeliness in returning interpretation results, performance monitoring, and quality assurance.

NTP radiologists interpret radiologic imaging studies submitted by radiology technologists from VA facilities and electronically transmit the interpretation reports to the originating facility. The OIG determined NTP has processes to ensure radiology provider competency through credentialing and privileging, provider professional practice reviews, and peer reviews for quality management (peer review). The radiologist involved in the misread had no deficiencies noted in reviews, and documentation supported renewal of privileges. 

While NTP has processes for completion of peer reviews, the OIG identified conflicting guidance about who is responsible for conducting peer reviews, NTP or the facilities. This lack of clarity led to delays, including a peer review completed over nine months after the misread. 

The OIG substantiated delays in the return of stat imaging interpretation reports at two facilities. NTP policy requires a one-hour turnaround for stat studies, but the OIG found delays in nine of thirteen reviewed cases. The OIG determined NTP did not meet performance goals for turnaround and average times for imaging studies in fiscal year 2024. Although NTP leaders took corrective actions, including reducing routine study volume, increased collaboration with staff at facilities using NTP, and planning a system upgrade, challenges persisted. 

The OIG made five recommendations. As a result, the Acting Under Secretary for Health agreed to address NTP’s staffing shortage and ensure facilities have a contingency plan. The NTP Director committed to addressing completion of peer reviews, delayed turnaround times, and staffing shortages.