eConsult systems improve communication between radiologists and referring providers by creating structured, documented consultations within electronic health records. A study of a pediatric radiology eConsult platform showed high provider satisfaction, increased adoption over time, and positive impacts on clinical decision-making.
- 257 eConsults were submitted through the platform between 2021 and 2025, averaging 6.8 per month
- 80.8% of providers reported that eConsults had a positive impact on their clinical decision-making
- 100% of surveyed providers reported satisfaction with the eConsult platform (Likert score ≥4)
- Usage increased significantly from 43 eConsults in 2022 to 76 in 2024, demonstrating growing adoption
- Most common uses were diagnostic interpretation (48.2%) and imaging planning (29.9%) questions
Electronic consult (eConsult) systems could improve communication in pediatric radiology, suggest findings published September 1 in the Journal of the American College of Radiology.
Researchers led by Navaira Shoaib, MD, from Massachusetts General Hospital in Boston reported success from their pediatric radiology eConsult platform in supporting structured, asynchronous communication within the electronic health record (EHR).
“Despite modest early utilization, it [provides] provides a documented pathway for non-urgent imaging questions and supports the consultative role of radiologists,” Shoaib and colleagues wrote.
Radiologists often provide informal consultations to referring clinicians that may not be formally documented in the EHR. And while eConsult systems provide a formal, documented, asynchronous, EHR-integrated mechanism for provider-to-provider communication, structured pathways for these systems are not well established in radiology.
The researchers suggested that pediatric radiology could benefit from structured consultation, since providers may have questions on interpretating complex findings, follow-up imaging, and surveillance imaging.
Shoaib and colleagues implemented an EHR-integrated pediatric radiology eConsult platform to promote structured, documented, asynchronous communication between pediatric providers and pediatric radiologists. They described their experience in implementing the platform, as well as use patterns, and surveyed radiologists and providers on their experiences in using the platform. The researchers used a five-point Likert scale to measure satisfaction.
The study included 257 eConsults submitted through the platform between 2021 and 2025, making for an average of 6.8 consults per month. The researchers reported the following findings:
Most eConsults stemmed from pediatric gastroenterology (n = 147, 57.2%) and primary care (n = 64, 24.9%).
Diagnostic interpretation (n = 124, 48.2%) and imaging planning (n = 77, 29.9%) were the most common categories.
eConsult use increased from 43 in 2022 to 73 in 2023 and 76 in 2024, pointing to progressive adoption.
Among providers (n = 26), all reported satisfaction (Likert ≥4), and 80.8% reported impact on clinical decision-making. And radiologists reported good usability with varied impact on workload.
The study authors suggested that formal EHR documentation could reduce communication errors tied to informal consultations. And while radiologists supported the use of the eConsult platform in a general sense, their perceptions toward workload and communication varied.
“Some viewed eConsults as an additional communication pathway rather than a substitute for telephone or reading room consultation, which is consistent with prior literature describing additional specialist responsibilities associated with electronic consultation models,” the authors wrote.
The authors also called for future studies to evaluate quantitative measures and better define the clinical and operational impact of pediatric radiology eConsult platforms.
Read the full study here.
