Sindy Byington

Project Title

Project OTTER: Overuse of Transfer TEsting from Rural Sites: Minimizing Overuse of Medical Testing in Hospital Transfers from Rural to Urban Setting

Project Overview

Project OTTER will focus on overuse and duplication of diagnostic testing on the specific population of hospital inpatient transfers to Billings Clinic Hospital in Billings, Montana from Critical Access Hospitals in the region. It is hypothesized that in transfer situations, both from rural ED and from rural inpatient settings, there may be a high level of unnecessary duplication in laboratory testing as well as imaging and other testing and procedures.

This project will provide the opportunity to:

  • Strengthen the relationship between urban and rural physicians in co-managing patient care
  • Identify and decrease possible overuse of medical procedures, tangibly advancing the organization’s commitment to quality, safety, and value
  • Support the training of internal medicine residents, including leadership as well as research skills development and
  • Improve patient satisfaction with their care


Billings Clinic Internal Medicine Residency Program

Meet the Team

Sindy Byington, MD, Resident Physician at Billings Clinic.  Sindy is a first year resident in the Internal Medicine Program at Billings Clinic.  She has a background in postgraduate microbiology research and working in a rural critical access hospital laboratory.  Her interest is in providing better access to primary care in rural areas. 

Jeannine Brant, PhD, Nurse Scientist at Billings Clinic.  Jeannine is an Oncology Nurse Specialist and Pain Consultant who has an extensive background in cancer symptom management, palliative care and the care disparities encountered by special populations, including native American and patients in rural/frontier areas.

Robert Ficalora, MD


Email: sbyington@billingsclinic.org