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Implementation and initial evaluation of needs-based remote consultation systems for musculoskeletal conditions in
Toru Imai1, Yasunari Kamiya2, Kenichi Mishima2
1Department of Orthopaedic Surgery, Aichi Children's Health and Medical Center, Obu, Japan; Department of Comprehensive Pediatric Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Insights
Remote consultation systems for pediatric musculoskeletal disorders are feasible and well-received. These systems help orthopedic surgeons manage complex cases, reduce diagnostic uncertainty, and improve patient care.
Area of Science:
- Orthopedics
- Pediatric Medicine
- Health Informatics
Background:
- Decreased opportunities for orthopedic surgeons to manage pediatric musculoskeletal disorders lead to diagnostic uncertainty.
- Remote consultation systems offer instant expert opinions and facilitate initial management.
- A needs assessment identified gaps in managing pediatric musculoskeletal conditions.
Purpose of the Study:
- To examine unmet needs in pediatric musculoskeletal disorder management.
- To implement and evaluate remote consultation systems for these conditions.
- To assess the impact of these systems on clinical decision-making.
Main Methods:
- Anonymous needs assessment survey of orthopedic surgeons (July 2023).
- Implementation of email-based and eConsult platforms (April 2024-November 2025).
- Post-use user feedback survey to evaluate system impact.
Main Results:
- 108 survey responses indicated significant need, with many surgeons managing pediatric cases without specialists.
- Two remote consultation systems were implemented, receiving 31 consultations from 23 physicians.
- User feedback showed high satisfaction (median 5/5) with usability and response, aiding management plans.
Conclusions:
- Needs-based remote consultation systems for pediatric musculoskeletal conditions are feasible and accepted.
- These systems appear to support clinical decision-making and reduce physician concerns.
- Remote consultations can enhance the management of pediatric musculoskeletal disorders.
Background:
Opportunities for orthopedic surgeons to manage pediatric musculoskeletal disorders have decreased, leading to increased diagnostic uncertainty and delayed referrals. The remote consultation system enables clinicians to obtain expert opinions instantly and facilitates initial management. We examined unmet needs for the management of pediatric musculoskeletal conditions through a needs assessment survey, implemented remote consultation systems, and evaluated its preliminary impact using a user feedback survey.
Methods:
In July 2023, we conducted a cross-sectional, anonymous needs assessment survey among orthopedic surgeons affiliated with our university network. Based on the survey findings, we implemented remote consultation systems for pediatric musculoskeletal disorders from April 2024 to November 2025. Finally, we conducted a post-use, anonymous user feedback survey to evaluate the overall system.
Results:
The needs assessment survey yielded 108 responses. Although 70 respondents worked in community hospitals without an in-house specialist, 78 respondents treated some children with musculoskeletal conditions within a year. Ninety-two respondents reported referring patients to specialty centers before completing treatment at their own hospitals. We implemented two systems-an email-based service and an electronic consultation (eConsult) platform-and received 31 consultations from 23 physicians. Consultation addressed treatment-related issues in 21 cases, diagnosis concerns in four, and both in six cases. The response rate for the user survey was 65.2%. Median (interquartile range) ratings were 5 (4-5) for overall usability, ease of consultation, and satisfaction with the response. Most users reported that expert's feedback helped determine management plans and alleviate clinical concerns.
Conclusions:
Needs-based remote consultation systems for pediatric musculoskeletal conditions were feasible and well accepted. The post-use assessment suggested that the systems may support clinical decision-making and reduce physician's concerns when managing pediatric musculoskeletal disorders.
