TOPIC: Diffuse Lung Disease TYPE: Original Investigations PURPOSE: Interstitial Lung Diseases represent a diverse collection of more than 200 diseases. Diagnoses are made based on patient history, chest CT imaging, laboratory evaluation, and occasionally tissue analysis. Prior to correct diagnosis and treatment plan, patients often receive incorrect diagnoses from multiple physicians. Delays in diagnosis and appropriate treatment lead to higher mortality rates. A multidisciplinary discussion (MDD) including pulmonologists, radiologists, pathologists, and rheumatologists has been shown to increase diagnostic accuracy and use of appropriate treatments. MDD is considered the gold standard for diagnosis. MDDs are resource intensive and typically only feasible at academic referral centers. For geographic, financial, and logistical reasons, rural and community pulmonologists and their patients have limited access to MDD. Furthermore, wait times at academic centers with ILD expertise can be substantial. To reduce diagnostic delays, improve accuracy, and reduce time to treatment initiation we have recently created a virtual MDD for rural and community physicians. METHODS: Rural and community pulmonologists submitted a standardized form with patient history, exam, lab findings, imaging findings, and what the working diagnosis, planned workup, and treatment plan were. Patients’ imaging studies were uploaded to our center. At the virtual MDD, dedicated chest radiologists provided their interpretation of the images without any additional clinical information. Then, the pulmonologist presented the patient’s pertinent history and lab findings. Following that, the group which included ILD sub-specialists, rheumatologists, and pathologists, would discuss their thoughts on the case. Data regarding changes in workup, diagnosis, and treatment plan were collected. RESULTS: To date, 20 patients have been presented by six community pulmonologists. Out of 20 patients, 13 had a preliminary diagnosis, planned workup, and treatment plan. In 12/13 (92%) patients there was a change in the initially planned treatment to an alternative agent or intervention following MDD. In 9/13 (69%) patients, there was a change in diagnosis following MDD with one patient being unclassifiable with available data. In 10/13 (77%) of patients, there was a change in further workup. CONCLUSIONS: Our community based ILD MDD often led to substantial changes in treatment, diagnosis, and recommended workup. Treatment was changed in all but one patient, which is especially important as timely initiation of appropriate treatment is imperative to improve or preserve lung function. This is especially true in certain ILDs with reversible etiologies. CLINICAL IMPLICATIONS: Community pulmonologist access to ILD MDD reduces diagnostic delays, improves diagnostic accuracy and reduces time to appropriate treatment initiation. DISCLOSURES: Speaker/Speaker's Bureau relationship with Boehringer Ingelheim Please note: 2019-Present Added 05/01/2021 by Chase Hall, source=Web Response, value=Honoraria Grand Funding relationship with Boehringer Ingelheim Please note: 2021-Present Added 04/30/2021 by Chase Hall, source=Web Response, value=Grant/Research No relevant relationships by Mark Hamblin, source=Web Response No relevant relationships by Christopher Streiler, source=Web Response