Imaging call hub bolsters bonds between radiologists, community PCPs, scoring 98% ED avoidance rate
Establishing a medical imaging call center has helped one Toronto health system strengthen bonds between radiologists and community primary care physicians, experts shared on Monday.
The practice has also helped University Health Network quash unnecessary trips to the emergency department about 98% of the time, with call volumes rising steadily. Based on their results, experts believe radiologists who make themselves more available to PCPs can help to mitigate malpractice risks while also building better ties with patients.
“Results indicate that an active engagement strategy is necessary and can lead to changes in patient management that will decrease the burden on other specialists,” corresponding author Jisla Mathews, MBA, with the Joint Department of Medical Imaging at University Health Network, and colleagues wrote Monday in JACR.
Community PCPs oftentimes face “considerable challenges” when accessing clinical services and information on patients. Delays or poor communication in this process can snowball into unneeded ED trips and adverse events, the team noted. To alleviate these pitfalls, UHN in 2014 launched a pilot study to test the effectiveness of a call center in helping primary care docs to confer more frequently with radiologists. After early success, the provider then fully operationalized the center, sharing contact info to all PCPs served by its downtown ambulatory care facility.
Two staffers operate the center, answering calls, coordinating requests and following up, Mathews and colleagues explained. They typically handle five different types of requests, with urgent imaging and appropriate use the two that require doc-to-doc interaction.
For the study, researchers tracked metrics during a 44-month period in which almost 2,300 calls were placed to the center. During the first half year of the evaluation, the average number of monthly calls increased by 39%, up to 61. That included consultations between PCPs and radiologists rising steadily, too. For calls in which primary care initially planned to send a patient to the emergency department, the team scored a 98% avoidance rate (215 out of 220 instances). Beyond that, radiologists answered more than 90% of urgent imaging and appropriate-use consultation calls in real time. Plus, physicians on both sides of the line reported satisfaction with the process.
Up next, they’ll look to further spread the intervention to other hospital-based imaging departments. The team emphasized the importance of a “robust engagement strategy,” strong radiologist support and participation, and frequent data collection.
“Making radiologists readily available for real-time in-person telephone consultation resulted in a growth of unique callers to our multi-site group and built relationships with community PCPs,” the team concluded. “This is particularly relevant to health maintenance organizations in the United States in which the PCP is often the gatekeeper. An approachable, available radiologist improves efficiency, helps mitigate medicolegal risk, and brings us closer to patients.”
Read more of the analysis in the Journal of the American College of Radiology here.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.