Pediatric Radiology eConsults: Implementation, Utilization, and Provider Experience in a large integrated academic and community-based health system.

Abstract

Radiologists frequently provide informal consultations regarding imaging interpretation, modality selection, and protocol planning. These interactions are valuable but often undocumented and may interrupt workflow. Electronic consultation (eConsult) systems enable asynchronous provider-to-provider communication within the electronic health record (EHR). To describe the implementation and early utilization of a pediatric radiology eConsult platform integrated within the EHR at a large academic pediatric healthcare system. This institutional review board-approved retrospective study evaluated an eConsult tool integrated into the Epic EHR between April 2021 and July 2025. The system enabled asynchronous communication between pediatric care providers and pediatric radiologists for non-urgent outpatient imaging-related questions. Consultation requests were extracted from the radiology database and categorized by provider type and consultation purpose. Provider and radiologist perceptions were assessed using structured REDCap surveys. A total of 257 eConsults were submitted (mean, 6.8/month). Most originated from pediatric gastroenterology (147/257, 57.2%) and primary care (64/257, 24.9%). The most common categories were diagnostic interpretation (124/257, 48.2%) and imaging planning (77/257, 29.9%). Utilization increased from 43 in 2022 to 73 in 2023 and 76 in 2024, indicating progressive adoption. Among providers (n = 26), all reported satisfaction (Likert ≥4), and 80.8% reported impact on clinical decision-making. Radiologists reported good usability with variable workload impact. A pediatric radiology eConsult platform supports structured, asynchronous communication within the EHR. Despite modest early utilization, it provides a documented pathway for non-urgent imaging questions and supports the consultative role of radiologists.