What to prepare for teleradiology onboarding

RADSTEAD RADIOLOGY | TELERADIOLOGY ONBOARDING CHECKLIST
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SCOPE AND VOLUMES
[ ] Examination list by modality, with approximate monthly volume. Include the routine and urgent mix and your busiest hours.
[ ] Coverage windows in the facility time zone. Include holidays, and who owns studies acquired near the end of a window.
[ ] Priority definitions and how turnaround is measured. Agree what STAT, urgent and routine mean, and where the clock starts and stops.
[ ] Preliminary or final reports, by modality and window. Overnight emergency work and daytime outpatient work often differ.
[ ] Responsibilities that stay onsite. Contrast supervision, procedures, medical direction and, for mammography, the lead interpreting physician role.

READER ELIGIBILITY
[ ] Licensure for the state where patients are imaged. Confirmed for every reader who may be assigned your studies.
[ ] Facility credentialing and privileges. Hospitals follow their medical staff process; outpatient centers follow their own policy and payer requirements.
[ ] Modality-specific qualifications. Including MQSA interpreting-physician requirements for mammography and DBT.
[ ] Primary and backup reader arrangements. Who reads when the primary reader is unavailable, for each window.
[ ] Billing responsibility for the professional component. Agreed alongside payer enrollment timelines.

SYSTEMS AND CONNECTIVITY
[ ] Image routing method. DICOM send from PACS or modality, a gateway, or another agreed route.
[ ] Network and security details exchanged through IT channels. Endpoints, AE titles, VPN or TLS settings go through your IT team’s secure process, not email or web forms.
[ ] Orders and clinical history. HL7 orders, a worklist or scanned requisitions: how the reason for the examination reaches the reader.
[ ] Prior studies for comparison. Sent with the new study, retrieved on request, or available through viewer access.
[ ] Report return. HL7 results to RIS or EHR, a document to PACS, or portal access, and who receives each copy.
[ ] Patient identifier and accession number rules. Especially across multiple sites, to prevent mismatched studies.

COMMUNICATION AND ESCALATION
[ ] Urgent-finding call list by location and time of day. Including who to call when the ordering clinician cannot be reached.
[ ] Where nonroutine communication is documented. Who was contacted, when, and by whom.
[ ] Contact route for technologists and referrers. For protocol questions, missing history and report clarifications.
[ ] Addendum and corrected-report notification. How changes reach the people who already acted on the first version.
[ ] Downtime contacts and procedure on both sides. What each side does when an interface or system is unavailable.

AGREEMENTS AND INFORMATION HANDLING
[ ] Service agreement. Scope, hours, service measures, reporting cadence, term and notice.
[ ] Privacy agreements and security review. Confirm each party’s role and complete any required business associate agreement before sharing protected information.
[ ] Evidence of professional liability coverage. For the readers and the arrangement being agreed.
[ ] Report and record access, including after the agreement ends. Where signed reports live and how they are retrieved later.

VALIDATION AND GO-LIVE
[ ] Test studies through the full pathway. Using approved test data, from acquisition to the final report’s destination.
[ ] Report delivery confirmed at every destination. RIS, EHR, PACS, referring offices and any fax or portal copies.
[ ] Urgent-call drill using the documented route. A rehearsal, recorded the way a real call would be.
[ ] Downtime and recovery walkthrough. Including how studies read during downtime are reconciled afterwards.
[ ] Go-live date and first review meeting scheduled. An early review catches routing and communication issues while they are small.

Business information only. Keep patient information, passwords and network details out of this checklist.
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