When the Virtually Impossible is Virtually Possible: Optimal Workflows and Consultation Types for Virtual Radiology Reading Rooms

Abstract

To 1) Determine whether virtual reading room (VRR) engagement endured after initial inception amidst the COVID-19 pandemic, 2) Understand factors affecting VRR utilization by radiologists and consulting providers. This Institutional Review Board-exempt study was performed at a large academic medical center. In response to pandemic-induced social-distancing requirements, divisional VRRs replicated the ability for provider "drop-in" consultation including speaking with a radiologist while viewing images together. Average daily users were compared between 7/1/2020-9/28/2020 (more stringent social-distancing guidelines) vs. 11/8/2021-2/5/2022 (more relaxed guidelines), using chi-squared tests. Focus group data on utilization within year one of inception was gathered from radiologists and consulting providers (Internal Medicine, Surgery, and Emergency Medicine), and responses used to predict probability of continued utilization post-social distancing. Linear regression compared 2022 total active user replies from inception through 1/31/22 with 2021 predictive divisional utilization data. There were no significant differences in average daily users during the 2020 period (73) vs. the 2022 period (65; p=0.09). 2022 VRR utilization was higher in radiology divisions with standardized workflows (relying more on cross-sectional imaging) than those with interrupted workflows (relying more on real-time imaging such as ultrasound), R2=0.86 (p<0.05). Radiology divisions receiving multidisciplinary management and long-term treatment planning questions had more long-term utilization than those receiving focused questions for triage, R2=0.79 (p<0.05). VRR engagement endured two years post-inception despite reduced social-distancing guidelines, indicating VRRs may serve as a lasting part of healthcare architecture. Reading room workflow and consulting provider question type predict VRR utilization at the divisional level.