"Misdiagnosis is a persistent problem, which needs to be reduced," states the site's home page. "Studies show a significant percentage of initial diagnoses are later proven to be inaccurate."
The site, www.YourMisdiagnosis.com, invites patients to post and share their experiences of diagnostic misdiagnoses, with two patients having taken up the invitation as of press time -- one who claims that Valley Fever was initially misdiagnosed as lung cancer, and another who claims that a lung infection was initially misdiagnosed as breast cancer metastasized to the lung. The latter patient claims that the misdiagnosis might not have happened if the case had been read by a lung diagnostic specialist rather than a general radiologist.
YourMisdiagnosis.com is owned and operated by MedSolutions and its wholly owned subsidiary, Premerus, both of Franklin, TN. Advertising for Premerus is displayed on the site, including the statement, "Reduce diagnostic errors through your health plan with Premerus diagnostic excellence."
The Web site was established in February 2008 to create an online community for patients and healthcare consumers to engage in a dialogue regarding misdiagnosis -- to share their stories, learn from others' experiences, and connect with them, according to Premerus marketing manager Matt Moynihan.
"The site is not intended to discredit the great work performed by diagnosticians, but it is intended to provide a forum for conversation that has not been available," the company said in a written statement to AuntMinnie.com.
Premerus describes itself as "the industry's first and only diagnostic management company representing the coordinated focus of resources, expertise, and technology to improve the accuracy of diagnosis." It uses a proprietary Web-based teleradiology system to refer customers such as employee health plans to prequalified radiology subspecialists, called certified Premerus experts, located across the U.S. The company does not derive any compensation from the professional fees that are paid to the experts for their diagnostic interpretations, according to Moynihan.
Although Premerus does not describe itself as a subspecialty teleradiology services company, it has all the characteristics of one. Procedures performed at participating nonemergent outpatient imaging facilities are transmitted to Premerus for dissemination to one of its certified Premerus experts for interpretation.
MedSolutions, Premerus' parent company, specializes in managing radiology services for national and regional health plans, as well as for federal and state government agencies. The company manages radiology services for nearly 25 million individuals nationwide, including 2.1 million individuals with Cigna HealthCare insurance plans.
Radiologists interested in becoming qualified as a certified Premerus expert are encouraged to submit their credentials to the company. The application process involves evaluation of a candidate's training, previous experience, and demonstration of expertise. Moynihan said that applicant radiologists are also required to take tests to become a certified Premerus expert.
Both Premerus' chief medical officer and its medical director are involved in the credentialing process, Moynihan said. The chief medical officer of both MedSolutions and Premerus is Dr. Greg Allen, a board-certified family medicine physician and a fellow of the American College of Emergency Physicians.
The company's medical director is Dr. Norman Scarborough, who was chief radiologist at Premier Medical Group of Clarksville, TN, a 40-physician multispecialty group practice specializing in pediatrics, family medicine, and internal medicine that also operates an in-house imaging center. Scarborough's experience also includes serving as chief radiologist of Graves-Gilbert Clinic, a multispecialty 60-physician practice in Bowling Green, KY, and as chief of the radiology department of Blanchfield Army Community Hospital in Fort Campbell, KY.
When asked if there could be a conflict of interest between MedSolutions and Premerus, the written statement provided by the company stated that "the aims and objectives of the Premerus program do not intersect in any manner with the goals for managing appropriate utilization of imaging studies."
The statement goes on to say that in markets where MedSolutions is performing prior authorization services to assess appropriateness of requested imaging studies, Premerus will use clinical data collected in that process. The data will better inform the Premerus expert who reads the study as to the clinical question being posed by the referring physician and will improve the accuracy of the interpretation by providing relevant clinical information at the time the study is read, the company said.
By Cynthia Keen
AuntMinnie.com contributing writer
May 27, 2008
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