Bridging the Gap Between Radiology and Primary Care: Expansion and Sustainability of a Medical Imaging Call Center Model

Ravi J Menezes; John Kavanagh; Emita Latif; Jennifer Catton; Corwin Burton; Catherine Wang; Jisla Mathews

doi:10.1016/j.jacr.2020.07.025

Bridging the Gap Between Radiology and Primary Care: Expansion and Sustainability of a Medical Imaging Call Center Model

J Am Coll Radiol. 2021 Mar;18(3 Pt A):406-412. doi: 10.1016/j.jacr.2020.07.025. Epub 2020 Aug 17.

Authors

Ravi J Menezes¹, John Kavanagh², Emita Latif³, Jennifer Catton³, Corwin Burton⁴, Catherine Wang², Jisla Mathews⁵

Affiliations

¹ Lumenus Community Services, Toronto, Ontario, Canada.
² Joint Department of Medical Imaging, University Health Network, Sinai Health, Women's College Hospital, Toronto, Ontario, Canada; Department of Medical Imaging, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
³ Joint Department of Medical Imaging, University Health Network, Sinai Health, Women's College Hospital, Toronto, Ontario, Canada.
⁴ Joint Department of Medical Imaging, University Health Network, Sinai Health, Women's College Hospital, Toronto, Ontario, Canada; Joint Department of Medical Imaging, Women's College Hospital, Toronto, Ontario, Canada.
⁵ Joint Department of Medical Imaging, University Health Network, Sinai Health, Women's College Hospital, Toronto, Ontario, Canada. Electronic address: jisla.mathews@uhn.ca.

PMID: 32818483
DOI: 10.1016/j.jacr.2020.07.025

Abstract

Objectives: The Medical Imaging Call Centre (MICC) was an initiative carried out by a hospital-based academic imaging department with the aim to provide navigational services and radiologist consultations to community-based primary care physicians (PCPs). The strategies used to expand and sustain the initiative over a 3.5-year period after an initial pilot are described.

Methods: The strategy to evolve the MICC had internal and external components. Internally, processes were refined to ensure satisfaction of stakeholders. Externally, a robust engagement strategy focused on recruiting and engaging callers was implemented. Metrics including call volumes, unique callers, and call type were monitored to track utilization and further inform the engagement strategy. A reduction in avoidable use of the emergency department (ED) was determined by tracking pre- and post radiologist consultation decisions reported by callers.

Results: During the evaluation period, 2,297 calls were made. There was a 39% increase in the average number of monthly calls in the last 6-month period (61) compared with the first 6 months (44). Call types that involved PCP-to-radiologist communication for patient management consultation also increased over time. A 98% ED avoidance rate (215 of 220) was reported for calls in which PCPs initially indicated that they would be sending their patients to the ED for urgent imaging if the MICC were unavailable.

Discussion: The MICC was successful in connecting community-based PCPs with hospital-based subspecialized radiologists. Results indicate that an active engagement strategy is necessary and can lead to changes in patient management that will decrease the burden on other specialists.

Keywords: Appropriateness; call center; communication; primary care; radiology.

MeSH terms

Call Centers*
Emergency Service, Hospital
Humans
Physicians, Primary Care*
Primary Health Care
Radiology*