01 · A practice built by the person reading the studies
Complicated exams, and a founder at the workstation
Charter Radiology runs two centers in Maryland, in Columbia and Reisterstown, and the newer of them opened in September 2020, which is to say, in the middle of a pandemic. Dr. Daisy Uppal founded the practice and still reads for it.
It is also not a plain-film shop. Her own summary is that they do very complicated exams and do not do simple stuff: a 128-slice PET CT cancer suite, DEXA with body composition, liver elastography, arthrograms. Complex work brings complex preparation, which used to mean calling and emailing patients one at a time to explain what to do before they arrived. And it brings walk-ins all day, which the practice serves same-day.
- Two centers, Columbia and Reisterstown, Maryland
- The newer center opened in September 2020
- Founded by the radiologist who still reads for it
- 128-slice PET CT, DEXA body composition, elastography, arthrograms
- Walk-ins all day, served same-day
02 · The failure that stayed invisible
Reports read in seconds, delivered in days
The previous system’s servers kept going down, and when they did, reports stopped being faxed to referring physicians. Nothing announced this. No alert, no bounce, no queue anybody was watching: the reports simply did not arrive, and Charter did not find out for days.
What made it worse is the reason it stayed hidden. Her referring physicians knew what the practice had cost her to build, so when a report was late they did not ring up to complain. The failure was concealed by their goodwill, and it surfaced only when someone eventually mentioned, in passing, that they had been waiting three days for a report she had read within seconds of the scan.
- Servers down, and outbound faxes silently stopping
- No notification, so the gap went unnoticed for days
- Referrers who chose not to complain, which hid it further
- Reports read in seconds, arriving three days late
Why it matters
“I didn’t get my report for three days. And I was like, I read it within seconds of the patient being imaged.”
Daisy Uppal, M.D., CEO and President
Charter Radiology
03 · Closing the gap
Out in seconds, and visible to everyone at once
Now reports and faxes leave within seconds of the read, which means the delivery finally matches the speed she was already working at. Referring physicians get the information while the clinical decision is still live, and the practice is not relying on anyone’s goodwill to find out whether it arrived.
Patients see their own images and reports immediately, and that changed the character of the front desk. The questions that used to land there (how do I get my images, where is my report) largely stopped, because the answer arrives before anyone has to ask. Her point about anxiety is worth taking literally: people come to Charter with serious conditions, and waiting is part of the illness.
- Reports and faxes out within seconds of the read
- Patients seeing their own images and reports immediately
- The image-and-report questions largely gone from the front desk
- Referring clinicians informed while the decision is still open
04 · The work that stopped being manual
Prep, eligibility and the tsunami
Two other things came off the team. Preparation instructions for complex exams used to be emailed and phoned through patient by patient; they are now sent automatically. And eligibility is checked in the system, which tells the practice, and the patient, whether prior authorization is needed before it becomes a problem on the day.
What Dr. Uppal notices is not the features but what the front desk can do with the time. Her image for the morning rush is a tsunami hitting the people at the forefront, and the difference now is that they can take care of the patient in front of them rather than fielding questions about paperwork. Asked to describe the platform in one word, she says transformational, and ties it directly to standing up against her competition.
- Prep instructions for complex exams sent automatically
- Eligibility checked, and prior authorization flagged in advance
- A front desk attending to patients rather than chasing documents
- A support team she describes as always answering “yes, we can do this”
Client story