Department of Radiology, University of Ottawa, 501 Smyth Rd, Box 232, Ottawa, ON K1H 8L6, Canada.
Department of Medical Imaging, The Ottawa Hospital, Ottawa, ON, Canada.
AJR Am J Roentgenol. 2020 Oct;215(4):929-933. doi: 10.2214/AJR.19.22270. Epub 2020 Aug 18.
The purpose of this study was to assess the use of an electronic consultation platform to connect primary care providers and radiologists and provide opportunities for valuable consultation regarding diagnostic imaging in patients, as well as to identify opportunities for targeted education surrounding high-yield radiology topics. A retrospective review was performed of consultations conducted using the electronic platform from September 2012 to January 2017. Consultations were classified by subspecialty (neuroradiology, thoracic, abdominal, musculoskeletal, or pediatric radiology), question type (workup, surveillance, education, specialist referral query, discharge, or other), anatomy, and pathology. Feedback surveys were completed by primary care providers after each consultation to evaluate timeliness, value, and impact on patient care. A total of 302 consultations were reviewed. Subspecialty breakdown was as follows: abdominal, 94/302 (31%); neuroradiology, 74/302 (25%); musculoskeletal, 61/302 (20%); thoracic, 56/302 (19%); and pediatric, 17/302 (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%]). Cystic lesions (38/302 [13%]), pain (24/302 [8%]), and bone lesions (21/302 [7%]) were the most queried conditions. Patient management was altered in 167 cases (55%), and unnecessary testing was avoided in 84 (28%). Providers rated the perceived value of the electronic consultation system as excellent in 227 cases (75%). The electronic consultation system allowed primary care providers to easily consult with radiologists, was perceived as high value by primary care providers, resulted in altered patient management, and avoided unnecessary imaging tests. We identified follow-up imaging of cystic lesions and imaging workup of pain in patients as opportunities for continuing medical education for primary care providers.
本研究旨在评估使用电子咨询平台将初级保健提供者与放射科医生联系起来，并为患者的诊断成像提供有价值的咨询机会，同时确定围绕高收益放射学主题进行针对性教育的机会。对 2012 年 9 月至 2017 年 1 月期间使用电子平台进行的咨询进行了回顾性审查。根据亚专业（神经放射学、胸部、腹部、肌肉骨骼或儿科放射学）、问题类型（检查、监测、教育、专家转诊查询、出院或其他）、解剖和病理学对咨询进行了分类。每次咨询后，初级保健提供者都会完成反馈调查，以评估及时性、价值和对患者护理的影响。共审查了 302 次咨询。亚专业细分如下：腹部，94/302（31%）；神经放射学，74/302（25%）；肌肉骨骼，61/302（20%）；胸部，56/302（19%）；儿科，17/302（6%）。大多数咨询涉及患者检查（112/302 [37%]）、影像学检查结果监测（95/302 [31%]）和提供者教育（48/302 [16%]）。囊性病变（38/302 [13%]）、疼痛（24/302 [8%]）和骨病变（21/302 [7%]）是最常询问的疾病。167 例（55%）患者的治疗方案发生改变，84 例（28%）避免了不必要的检查。227 例（75%）提供者对电子咨询系统的感知价值评为优秀。电子咨询系统使初级保健提供者能够轻松与放射科医生进行咨询，被初级保健提供者认为具有高价值，导致患者管理方案发生改变，并避免了不必要的影像学检查。我们确定了对囊性病变的后续影像学检查和对疼痛患者的影像学检查作为初级保健提供者继续教育的机会。
