Purpose or Case Report: To evaluate the usability, workflow impact, and communication effectiveness of an asynchronous electronic consultation (e-Consult) platform implemented within pediatric radiology department. The platform was assessed from the perspectives of both pediatric care providers and radiologists following its integration at a tertiary academic medical center.
Methods & Materials: A custom-built e-Consult system was integrated into the Epic EHR and linked with Nuance Workflow Orchestrator, PowerScribe One, and Visage PACS. This system supported non-urgent outpatient consultations and was specifically designed to align with the workflows of radiologists. Between April 2022 and June 2025, pediatric care providers who placed e-Consults and pediatric radiologists who reviewed them were surveyed post-implementation. The survey included 5-point Likert-scale items and open-text responses that focused on satisfaction, workflow impact, and communication.
Results: A total of 257 pediatric radiology e-Consults were submitted, with the majority originating from Pediatric Gastroenterology (57.2%), Primary Care (24.9%), and Endocrinology (7.0%). Among 77 invited pediatric providers, 26 responded (33.8%), all with prior experience using the platform.

- Satisfaction: 100% reported satisfaction; 88.5% rated ordering as “very easy.”
- Efficiency: 76.9% described the process as “much easier” than previous methods; 80.8% cited positive impact on clinical decision-making.
- Communication: Prior contact methods included in-person (42.3%), phone (23.1%), and email (19.2%). e-Consults were favored over all.
- Radiologists’ Feedback: Rated ease of use (4.12/5), efficiency (4.00/5), and overall satisfaction (3.88/5); noted concerns about communication fragmentation and workload. Suggested improvements included triage optimization and scope-based consult filtering.
Conclusions: This pilot study demonstrates that a pediatric radiology eConsult platform facilitated timely, well-documented communication between pediatric care providers and radiologists, frequently resolving clinical questions without the need for in-person referrals or unnecessary imaging. However structured templates,shared expectations, and clear roles across referring and consulting providers are essential to reduce ambiguity, optimize workload distribution, and ensure legal and clinical clarity.