Mass General, Kent Hospital halt teleradiology talks

Jul 9, 2007

Negotiations on a contract in which Massachusetts General Hospital (MGH) would use its teleradiology program to take over most of the radiology services at a community hospital in Rhode Island ended last month with no agreement, quelling -- if only temporarily -- a controversial issue that received national attention.

The prospect of Boston-based Mass General crossing state lines to provide teleradiology services for the 359-bed Kent County Memorial Hospital in Warwick drew fire from the Rhode Island Radiology Society (RIRS) and Warwick-based Toll Gate Radiology, which has been interpreting patient images at Kent for the last three decades. Local radiologists accused Mass General of predatory behavior and of setting a precedent that would see academic radiology centers using teleradiology to take business from community radiology groups.

The RIRS was so rankled by the possibility of Mass General coming to Rhode Island that the organization brought the issue before the American College of Radiology's (ACR) Annual Meeting and Chapter Leadership Conference (AMCLC) in May.

Kent Hospital spokesperson Brian Wallin said that "after a series of very positive discussions, Kent and Mass General Radiology Associates have decided not to pursue a relationship." MGH spokesman David Avruch said "the discussion has stopped, because an agreement suitable to all parties was never reached. Neither would elaborate or cite reasons for the inability to forge an agreement.

One-month reprieve for Toll Gate

The inability of Mass General and Kent to consummate a contract comes as good news for local radiologists, but not necessarily for Toll Gate. "It keeps it (the contract) in the community and benefits people around here," said Dr. Julie Armada, radiologist and co-owner of Toll Gate Radiology. "If there were no radiologists willing to do this or not available, that would be a different story."

Last month, Kent distributed an RFP (request for proposal) for a radiology practice to service its estimated 140,000 annual imaging studies. Armada said the new contract would include "existing people" at Kent, but added that Toll Gate was not allowed to submit a proposal on its own, "because we allegedly did not have the manpower."

Toll Gate currently has three full-time radiologists and utilizes part-time radiologists, physicians, and NightHawk Radiology Holdings of Coeur D' Alene, ID, for weekend and off-hours reading. One of Toll Gate's full-time radiologists is planning to take another position by the end of the year.

"We have received responses to our RFP," Kent's Wallin said. "We are evaluating them. We would expect to make a decision on a provider in about a month's time." That timeframe would have Kent awarding a contract in early August.

Local competition

He declined to disclose the number of RFPs received or the radiology practices vying for contract. However, according to Armada, the competition is between three Rhode Island groups -- Imaging Network of Rhode Island in Providence, Barrington-based Rhode Island Medical Imaging, and Warwick-based XRA Medical Imaging.

While Kent was extending its RFP and terminating contract talks with Mass General, Toll Gate became increasingly frustrated with the situation. In early June, the practice exercised its 30-day notice with the hospital that it would no longer provide radiology services after July 9.

"When we found out the Mass General deal was off and the hospital was taking its sweet time to figure out what to do, we had the (option of exercising the) 30-day service agreement," said Toll Gate co-owner and radiologist Dr. Anthony Bruzzese. "We said, 'We'll just give the 30-day notice and put their feet to the fire.' "

Despite lapse of the 30-day notice on July 9, Bruzzese said the group continues to provide readings for Kent.

Toll Gate may stay involved with Kent, as the practice currently is mulling a merger with one of the three groups bidding on the radiology contract. Bruzzese said merger talks began in January, but were put on hold -- as were plans for Toll Gate to hire more staff -- when Kent began its discussions with Mass General.

ACR resolution

The issue of academic institutions providing teleradiology service was brought to the ACR's AMCLC in May by the Rhode Island Radiology Society. The basis of the group's resolution was the belief that radiology is best practiced by onsite radiologists and that teleradiology should be used an adjunct, in situations where direct, onsite reading is not possible, or to supply subspecialty expertise.

The resolution also asked the ACR to reaffirm that "cooperative, noncompetitive relations between academic and private-practice groups best serve the needs of our patients and the future of our specialty."

Bruzzese, who was at the meeting, said the resolution received a mixed reception, with some opposition coming from attendees who thought the ACR should not get involved in local disputes.

The resolution eventually was tabled for later consideration with no other action taken.

By Wayne Forrest
AuntMinnie.com staff writer
July 10, 2007