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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.
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.
