Technology-Assisted Virtual Consultation for Medical Imaging

Purpose: The aim of this study was to report the investigators' preliminary experience in the implementation of a "virtual consult" (VC) system enabling consultations between radiologists and referring physicians in physically remote locations throughout their enterprise. Methods: Referrers and radiologists directly access the VC through the electronic medical record and PACS, respectively. Referrers may click a VC link associated with any examination report to instant message the appropriate subspecialist radiologist, who receives an alert allowing automatic loading of the examination. The radiologist and referrer may then discuss the examination via instant messaging as well as launch a real-time screen-share of the radiologist's PACS display, with the option for either participant to control the display. Radiologists' and referrers' feedback was evaluated after the institution's first 110 VC sessions. Results: Referrers' most common specialties were emergency medicine (27.3%) and internal medicine (13.6%); radiologists' most common subspecialties were abdominal (33.6%) and thoracic (16.4%) imaging. Screen-shares lasted on average 12 +/- 16 minutes. From 80% to 90% of referrers agreed that the VC was easy to use, improved their understanding of the radiology report, affected patient management, and enhanced radiologists' role. Referrers found the VC to be particularly useful when traditional consultation was difficult because of location or time constraints or when seeking a quick response to a targeted question. Radiologists recognized referrers' positive response to the VC, although they tended to view the VC as disruptive to normal workflow. Conclusions: The VC addresses a key challenge in the current era of digital radiology practice and provides added value to referrers, though continued radiologists' workflow optimization is warranted.