E-Consults in Pediatric Radiology: A Pilot Study of a Novel Electronic Consultation Service Connecting Pediatric Care Providers to Pediatric Radiologists

Background Electronic consultations (eConsults) have gained widespread use across medical specialties; however, radiology, particularly pediatric radiology, has lagged in adoption. Pediatric care increasingly depends on timely subspecialty input, and traditional communication methods with radiologists can be fragmented. Objective To evaluate the feasibility, utility, and impact of a structured pediatric radiology eConsult platform implemented within a large academic quaternary pediatric care setting. Materials and Methods This IRB-approved, retrospective study evaluated an eConsult tool integrated into the Epic electronic health record (EHR) between April 2022 and June 2025. The tool facilitated asynchronous communication between pediatric care providers and pediatric radiologists. Data from 257 eConsults were extracted and categorized thematically. Provider and radiologist perceptions were assessed via REDCap surveys. Results Most eConsults originated from gastroenterology (57.2%) and primary care (24.9%). Thematic categories included diagnostic interpretation support (48.2%) and protocol planning (29.9%). Among pediatric care provider survey respondents (n = 26), 100% were satisfied, and 80.8% reported that eConsults altered their clinical decision-making. Radiologists found the system usable, with mixed views on workload impact and collaboration. Conclusion Structured eConsults in pediatric radiology are feasible, well-received, and may enhance access to imaging guidance and clinical decision-making. Their broader implementation can support efficient, scalable specialty communication.