Clinical and economic benefits of the Intellispace Portal applications CT TAVI and Spectral CT: Findings from a two-step Delphi panel

Background: IntelliSpace Portal (ISP) is an advanced visualization platform that offers a single integrated solution designed to help physicians work more efficiently. This study aimed to develop a consensus statement on the clinical and economic benefits of two Intellispace Portal (ISP) applications (computed tomography (CT) transcatheter aortic-valve implantation (TAVI) and Spectral CT) applications. Methods: A modified Delphi method of two rounds of queries was used in a panel of 17 experts (11 for Spectral CT and 8 for CT TAVI). The experts were identified via referral and selected to achieve a balanced representation of subject matter experts. The Delphi process was conducted online using the MESYDEL platform. Two rounds of Delphi queries were conducted between July 22 and October 14, 2019. All data was collected prospectively. Results: Areas of consensus represented contribution of ISP applications toward quadruple aim goals. Consensus was reached that the Spectral CT application led to more confident decision making, improved diagnosis capabilities leading to better treatment paths, and a better work experience. Panelists noted that they required fewer tests to make a diagnosis using Spectral CT. The majority of physicians (63%) agreed that CT TAVI led to time savings for ‘device sizing’ results, and 75% of physicians agreed that the tool resulted in a better work experience. Conclusions: The increased diagnostic confidence of spectral information could eliminate the need for many follow-up scans in patients, resulting in clinical benefit to the patient in terms of reduced exposure to radiation and economic benefit to healthcare systems in reducing the number of additional scans. The staff satisfaction goal of the quadruple aim is also satisfied by Spectral CT and CT TAVI leading to a better work experience in our panelist physicians. This may result in indirect benefits such as reduced rates of physician burnout and greater provider satisfaction.