Improving the quality of care through routine teleradiology consultation.
OBJECTIVE
The hypotheses of this study were as follows: (a) University subspecialty radiologists can provide consultations effectively to general radiologists as part of routine clinical operations; (b) these consultations will improve the quality of the final radiologic report; and (c) the consultations will improve the care process and may save money, as well.


METHODS
For 2,012 consecutive computed tomographic or magnetic resonance (MR) imaging studies, the initial interpretations provided by radiology generalists were subsequently reviewed by specialists, with a final consensus report available. "Truth" was established by final consensus reports. To control for potential bias, 150 adult MR imaging and 250 pediatric radiologic studies were interpreted initially by specialists and then by generalists. Again, truth was established by final consensus reports.


RESULTS
There was disagreement between generalist and specialist radiologist interpretations in 427 (21.2%) of the cases reviewed. These disagreements were stratified further by independent specialists, who graded them as important, very important, or unimportant. Differences were considered important or very important in 99% of the cases reviewed.


CONCLUSIONS
Consultations by subspecialty radiologists improved the quality of the radiology reports studied and, at least in some cases, improved the process of care by eliminating unnecessary procedures or suggesting more specific follow-up examinations. The consultation services can be provided cost-effectively from the payer's perspective and may save additional costs when unnecessary procedures can be eliminated.
Kangarloo
H
H
Department of Radiological Sciences, UCLA School of Medicine, Los Angeles, CA 90024, USA.
Valdez
J A
JA
Yao
L
L
Chen
S
S
Curran
J
J
Goldman
D
D
Sinha
U
U
Dionisio
J D
JD
Taira
R
R
Sayre
J
J
Seeger
L
L
Johnson
R
R
Barbaric
Z
Z
Steckel
R
R
D006801:Humans; D008279:Magnetic Resonance Imaging; D011787:Quality of Health Care; D019114:Remote Consultation; D019112:Teleradiology; D014057:Tomography, X-Ray Computed