Utilization of imaging reports for management of suspected lumbar spinal stenosis in the Veterans Administration

Abstract

Background and PurposeThe interprofessional gap between neurosurgeons and neuroradiologists has been increasing steadily since the implementation of electronic health record systems and remote radiology readings. Our aim was to survey and report the current practices employed by neurosurgeons in utilizing neuroradiology reports for management of patients with lumbar spinal stenosis. Materials and MethodsA voluntary survey was distributed among a group of neurosurgeons affiliated with the United States Veterans Affairs Health System. Survey questions were aimed at assessing the trends and the subsequent practice patterns in neurosurgical utilization of neuroradiology reports in patients with LSS. Results20 out of 43 respondents across all surveyed VAHS centers completed the survey, achieving a 46.5% response rate. 95% (19/20) of respondents had an on-site radiologist, while 80% (16/20) had access to a neuroradiologist. 95% (19/20) of respondents report having imaging routinely read by a neuroradiologist. 40% (8/20) of the neurosurgeons read the ordered radiology reports less than 50% of the time. Only 20% of respondents always read the neuroradiology report. 60% (12/20) of the surveyed neurosurgeons frequently reported major discrepancies between imaging interpretation among neuroradiologists and the surveyed neurosurgeons, with only 45% (9/20) neurosurgeons contacting the neuroradiologist to discuss discrepancies. Furthermore, a majority of neurosurgeons do not routinely participate in conferences where imaging is discussed. ConclusionsOur results suggest that the increase in teleradiology and remote readings may cause neurosurgeons to largely ignore radiology reports and major discrepancies in imaging interpretation when treating suspected LSS. Whether such practices lead to altered surgical outcomes and affect healthcare costs warrants further investigation.