Virtual, Point-of-Care Radiology Consultations Help Optimize Patient Care

Patients who participate in virtual consultations with radiologists are reporting a positive overall experience and a better understanding of their condition, new research shows.

Daye

In a study conducted at Massachusetts General Hospital (MGH), Boston, researchers determined that patients who participated in synchronous, virtual consultations with their primary care provider (PCP) and a radiologist reported having a better understanding of their disease and were more actively involved in management decisions.

Though preliminary, these results suggest that virtual radiology consultations add value for clinicians and patients by helping optimize patient-centered care.

“With the emergence of Accountable Care Organizations, radiologists are more incentivized than ever to evaluate new methods for interdisciplinary collaboration,” said presenter Dania Daye, MD, PhD, instructor of radiology at MGH/Harvard Medical School.

According to Dr. Daye, radiology consultation clinics are an emerging model of care in which radiologists actively participate in delivering imaging findings to patients.

Cluster-Randomized Study Model

Dr. Daye and her MGH colleagues had previously demonstrated the feasibility of in-person radiology consultations. In this study, by using a cluster-randomized study, they hoped to determine whether this care model added significant value for clinicians and patients.

The study centered on providing and assessing synchronous, video-based, virtual consultations for patients with vascular atherosclerosis. Participants older than 45 years of age who had consulted with a primary care provider enrolled in the study about vascular atherosclerosis and had a CT of the chest, abdomen or pelvis within the last two years were included.

While the initial design called for 200 subjects, the team was only able to enroll 91 patients due to the COVID-19 pandemic. Of those, 55 were selected for intervention, receiving virtual, real-time point-of-care consultations with their primary care provider and a radiologist who shared imaging results with them directly.

In the control group, 36 patients received the current standard of care without virtual radiology consultation. The participants were age- and gender-matched. However, Dr. Daye noted that the delays in the study interrupted age matching, and the control patient group represented was slightly older than the intervention group.

During the initial visit and again at one year, patients were assessed for lipid profile, blood pressure, weight and Framingham risk score.

The outcome for each case was assessed on four metrics: patient satisfaction, prescription changes, patient understanding of the disease and primary care physician/radiologist satisfaction. Only two out of five control patients reported discussing imaging with their primary care physician compared to all patients in the intervention group.

Imaging Discussion Aids Patient Understanding

One out of five control patients felt that the imaging discussion helped improve their understanding of their disease.

“Interestingly, not a single patient in the control arm was shown any of their medical images,” Dr. Daye said.

Virtual consultations with radiologists may have led to changes in treatment decisions, the study showed. Overall, the study shows that radiology-led virtual visits have a positive effect on patient shared decision-making metrics that might change patient care management.

“It remains to be seen whether these trends will hold up as we complete enrollment in the study,” Dr. Daye said.

For More Information

View the RSNA 2020 session Point-of-Care Synchronous Virtual Radiology Consultations: Preliminary Results from A Cluster-Randomized Study in Primary Care Patients — SSHS03 at RSNA2020.RSNA.org.

Watch Dania Daye, MD, PhD, Susan E. Bennett, MD and Nikhita Nambiar discuss the preliminary results from their cluster-randomized study in primary care patients.