Radiology call center reduces ED visits, makes primary care physicians happy

1-800 Imaging is a pilot program developed in Canada to help connect primary care physicians (PCPs) with radiologists and help decrease the use emergency departments (EDs). Heidi Schmidt, MD, department of medical imaging at the University of Toronto in Toronto, Ontario, Canada, and colleagues wrote about the program’s success for the Journal of the American College of Radiology, pointing to many ED visits that were able to be avoided altogether and high physician satisfaction scores.

The program revolved around a single phone line given out to certain PCPs, and they were told that on Monday through Friday, from 9 a.m. to 5 p.m., they would be able to reach a call center agent who could immediately assist them. The call center was initially able to offer consultations, urgent imaging services, and general information related to radiology. In cases of potential acute neurovascular events, callers were told to seek “immediate treatment” at their local ED.

Schmidt and colleagues said call center agents would either answer the caller’s question or connect them with the lead radiologist.

“The goal was to respond to each inquiry in real time; however, if a radiologist was not available, a mutually convenient time was determined and a return call was scheduled,” the authors wrote. “The call center agent remained on the line while the PCP and radiologist were in discussion to document the conversation and provide additional support if required (e.g., if the radiologist approved urgent imaging, the call center agent proceeded to coordinate the examination).”

So was the program popular? From May 2014 to March 2015, the call center answered 227 call. Twenty-two PCPs used the service more than one, and one frequent user placed a total of 31 different calls.

“Frequent use of the direct link between PCPs and medical imaging during the pilot is not surprising in the Canadian health care environment, where there is high demand for medical imaging from the primary care community,” the authors wrote. “Forty percent of Canadian PCPs report that their patients often experience difficulty getting specialized diagnostic tests such as CT imaging, mammography, and MRI.”

One of the primary goals of the program was to limit ED visits, and Schmidt et al. reported that it was successful in that regard. The authors estimate that at least 40 ED visits were avoided thanks to PCPs using the call center.

Also, physician satisfaction for the program was 100 percent, with every PCP reporting that they were satisfied with the call center and would recommend it to their colleagues.

“Collaboration between primary care and radiology will ultimately enhance patient care and decrease the burden on the ED and specialist health care systems,” the authors wrote. “Given the high prevalence of disconnected relationships between primary and specialty care in Canada, the lessons learned from this pilot have potential broad applications.”