Electronic consultations between primary providers and radiologists improve patient care

Electronic consultations between primary providers and radiologists improve patient care
Example of interactions between primary care physician (PCP) and radiologist illustrate use of software. yo = year-old, ER = emergency room, f/u = follow-up. Credit: American Roentgen Ray Society (ARRS), American Journal of Roentgenology (AJR)

According to ARRS' American Journal of Roentgenology (AJR), electronic consultation not only offered primary care providers (PCPs) easy access to expert opinions by radiologists, it promoted collaboration between physicians that improved patient care, including avoiding unnecessary imaging tests.

"The eConsult (Champlain BASE) electronic platform was developed to provide a secure method for PCPs to ask a specialist patient-specific questions supported by relevant clinical information," explained first author Daniel Walker at the University of Ottawa.

Of the 20,678 eConsults completed through the service to all participating specialists from September 2012 to January 2017, 307 (1.48%) were sent to radiologists—classified by subspecialty (neuroradiology, thoracic, abdominal, musculoskeletal, or pediatric radiology), question type (workup, surveillance, education, specialist referral query, discharge, or other), anatomy, and pathology.

To evaluate timeliness, value, and impact on , Walker and team had PCPs complete feedback surveys after each consultation.

Electronic consultations between primary providers and radiologists improve patient care
Text of survey administered to study participants. Q = question. Credit: American Roentgen Ray Society (ARRS), American Journal of Roentgenology (AJR)

The Canadian researchers excluded five eConsults from their analysis due to insufficient clinical information, so of the 302 total consultations they reviewed, the subspecialties broke down accordingly:

  • abdominal (94/302 [31%]),
  • neuroradiology (74/302 [25%]),
  • musculoskeletal (61/302 [20%]),
  • thoracic (56/302 [19%]),
  • pediatric (17/302 [6%]).

With regard to anatomic subclassification, eConsults most often pertained to the brain (47/302 [16%]), lungs (30/302 [10%]), spine (29/302 [10%]), and liver (27/302 [9%]).

Further subclassification revealed the most common conditions were cystic lesions (38/302 [13%]), pain (24/302 [8%]), bone lesions (21/302 [7%]), and nodules (18/302 [6%]).

The majority of consultations pertained to patient workup (112/302 [37%]), surveillance of imaging findings (95/302 [31%]), and provider education (48/302 [16%]).

Electronic consultations between primary providers and radiologists improve patient care
With regard to anatomic subclassification, eConsults most often pertained to the brain (47/302 [16%]), lungs (30/302 [10%]), spine (29/302 [10%]), and liver (27/302 [9%]). Further subclassification revealed the most common conditions were cystic lesions (38/302 [13%]), pain (24/302 [8%]), bone lesions (21/302 [7%]), and nodules (18/302 [6%]). Credit: American Roentgen Ray Society (ARRS), American Journal of Roentgenology (AJR)

Patient management was altered in 167 cases (55%), and unnecessary testing was avoided in 84 cases (28%). Meanwhile, in 227 cases (75%), PCPs rated the perceived value of the eConsult platform as "excellent."

"It may be helpful for radiologists to alter their reporting style to include clear follow-up guidelines for incidental findings," Walker et al. concluded, adding that PCPs may also benefit from continuing medical education on cystic lesion imaging, as well as imaging's role in the workup of patient pain.


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More information: Daniel Walker et al, Electronic Consultation Between Primary Care Providers and Radiologists, American Journal of Roentgenology (2020). DOI: 10.2214/AJR.19.22270
Citation: Electronic consultations between primary providers and radiologists improve patient care (2020, August 19) retrieved 26 October 2020 from https://medicalxpress.com/news/2020-08-electronic-primary-radiologists-patient.html
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