Virtual radiology rounds: adding value in the digital era.

BACKGROUND: To preserve radiology rounds in the changing health care environment, we have introduced virtual radiology rounds, an initiative enabling clinicians to remotely review imaging studies with the radiologist. OBJECTIVE: We describe our initial experience with virtual radiology rounds and referring provider impressions. MATERIALS AND METHODS: Virtual radiology rounds, a web-based conference, use remote sharing of radiology workstations. Participants discuss imaging studies by speakerphone. Virtual radiology rounds were piloted with the Neonatal Intensive Care Unit (NICU) and the Congenital Cardiovascular Care Unit (CCVCU). Providers completed a survey assessing the perceived impact and overall value of virtual radiology rounds on patient care using a 10-point scale. Pediatric radiologists participating in virtual radiology rounds completed a survey assessing technical, educational and clinical aspects of this methodology. RESULTS: Sixteen providers responded to the survey; 9 NICU and 7 CCVCU staff (physicians, nurse practitioners and fellows). Virtual radiology rounds occurred 4-5 sessions/week with an average of 6.4 studies. Clinicians rated confidence in their own image interpretation with a 7.4 average rating for NICU and 7.5 average rating for CCVCU. Clinicians unanimously rated virtual radiology rounds as adding value. NICU staff preferred virtual radiology rounds to traditional rounds and CCVCU staff supported their new participation in virtual radiology rounds. Four of the five pediatric radiologists participating in virtual radiology rounds responded to the survey reporting virtual radiology rounds to be easy to facilitate (average rating: 9.3), to moderately impact interpretation of imaging studies (average rating: 6), and to provide substantial educational value for radiologists (average rating: 8.3). All pediatric radiologists felt strongly that virtual radiology rounds enable increased integration of the radiologist into the clinical care team (average rating: 8.8). CONCLUSION: Virtual radiology rounds are a viable alternative to radiology rounds enabling improved patient care and education of providers.

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.