Can virtual consults mitigate reading room 'chaos'?

By Will Morton, staff writer

February 2, 2023 -- Referring providers prefer virtual radiology consults to phone calls -- and this type of consultation may help curb reading room "chaos" caused by phone interruptions, according to a study published January 25 in the Journal of Digital Imaging.

A team led by Dr. Joseph Yacoub of Medstar Georgetown University Hospital assessed initial perceptions of radiologists and referring providers participating in a pilot program they developed called the "Virtual Radiology Reading Room" (VR3). According to survey responses, 70% of participants preferred VR3 to phone calls, they found.

"Phone calls coming to the reading room are a major source of interruptions, which has led some institutions to employ reading room assistants to help manage the chaos," the researchers wrote.

Providing consultation to referring providers is one of the key responsibilities of radiologists. Currently, the vast majority of these consults are conducted informally, primarily through the radiology reading room phone, with interruptions occurring between two and 27 times per hour, according to the authors.

Yacoub's team launched phase I of VR3 in 2021, offering virtual consults to all providers at their hospital. How the initiative works is that referrers submit consults using a web application that allows the sender to choose a callback method (Microsoft Teams vs. phone number), include patient information, include a text question, mark the consult urgent if desired, and select a specific reading room (that is, body, neuroradiology, or musculoskeletal). The consults are routed to a group of radiologists covering the specified reading room; the radiologists are notified of the consults on Microsoft (MS) Teams, which is integrated into their workstations.

One of the radiologists claims the consult and responds to it via MS Teams where they can utilize voice call, text, screen share, and/or video as they see best (or via phone if sender selected phone callback). Once a radiologist claims the consult, it is no longer visible to the rest of the team.

In the first eight months of deployment, 71 unique referring providers used VR3 to send approximately 200 consults. These users, as well as 44 additional radiologists, were asked in a survey about their overall impressions, as well as how it compares to traditional phone calls to the reading room. Forty referring providers and 27 radiologists responded.

Overall, referrers gave the VR3 program 4.7 out of 5 stars, while radiologists gave it 4.1 out of 5 stars. Seventy percent of referrers and radiologists preferred VR3 to the phone, while 4.5% of referrers and 11% of radiologists preferred the phone.

"These results are critical because achieving the full potential of this solution hinges on changing referring providers practice patterns and habits," the authors wrote.

To their knowledge, there is only one published description of a virtual consult system used in radiology, and further research is warranted, the authors noted.

"We are currently piloting the solution in an affiliated community hospital to prove its value beyond academic radiology departments," Yacoub and colleagues concluded.

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