System-wide expansion of pediatric subspecialty radiology coverage using a centralized interpretation platform across 33 hospitals

The availability of fellowship trained pediatric radiologists has been limited to larger hospitals and specialty care centers, limiting access in community and non-children's hospitals. We evaluated the impact of a centralized imaging interpretation platform on redistribution of pediatric subspecialty radiology coverage and report turnaround time across a large multi-hospital network.

Using a billing audit, all radiology examinations for patients under 18 years of age were retrospectively reviewed from 33 hospitals across Michigan in two 6-month intervals between February 1, 2021, and February 8, 2023: Pre-implementation and post-implementation of a common EMR-PACS system. The proportion of studies reported by a pediatric radiologist and TAT were compared across periods.

A total of 191,250 examinations met inclusion criteria. Interpretation by pediatric specialists at non-children's hospitals across the state increased from 38.9% pre-implementation to 73.8% post-implementation, an absolute increase of 34.9 percentage points. Pediatric radiologist coverage at the children's hospital increased from 84.4% to 91.2%. At the system level, pediatric subspecialty interpretation increased from 68.1% to 82.5%. Weighted average report turnaround time improved from 8 hours 47 minutes to 5 hours 35 minutes, representing a reduction of 3 hours and 12 minutes. Benefits of pediatric radiologist coverage include increased diagnostic accuracy and evidence based and up to date management recommendations, which translates into better patient outcomes.

These findings demonstrate a scalable model for redistributing pediatric radiology expertise across multi-hospital systems and expanding subspecialty coverage beyond tertiary care centers.