Guide · Scope
How to scope teleradiology coverage
A good scope answers four questions: what needs reading, when, how fast, and what stays onsite. This guide works through each one, with a tool that shows where your imaging hours outrun your local reading.
1. Map demand by hour
Pull a month of examination counts by modality, hour and day of the week from your RIS. Busy hours, quiet hours and weekends usually differ more than expected, and the pattern matters more than the monthly total.
2. Find your coverage gaps
Enter when studies are acquired and when your own radiologists read. The grid shows the hours when studies wait for a reader. The example is an outpatient center scanning later than its local reading.
The coverage-gap tool needs JavaScript to recalculate. The example below shows how it reads.
Each window starts on the selected day. An earlier end time continues into the next day, including Sunday into Monday. Hours are local facility time.
26 hours a week with imaging but no local reader, 37% of imaging hours.
- Monday–Friday07:00–08:00
- Monday–Friday17:00–20:00
- Saturday08:00–14:00
Patterns to explore
- Evenings & weekends. Gaps at the edges of the day and at weekends point to an extended-hours window.
3. Define priorities and how turnaround is measured
Write down what STAT, urgent and routine mean for your facility, how each is flagged in the RIS, and where the turnaround clock starts and stops for each. Without shared definitions, turnaround numbers cannot be compared. See how measures are defined.
4. Choose a coverage pattern
Daytime reading
Imaging centers and departments where local radiologist time is limited, or where routine work builds up during clinic hours.
Evenings & weekends
Facilities with late scanning hours, weekend outpatient sessions, or hospital services that slow down but never stop.
Overnight
Hospitals and emergency departments that need interpretation while their own radiologists are off.
Overflow & backlog
Radiology practices and imaging groups with seasonal peaks, vacations, recruitment gaps or a backlog to clear.
Modality-specific
Facilities adding a modality without the local reading depth or volume to staff it full-time.
5. Draw the onsite line
List the responsibilities that stay onsite so nobody assumes they come with remote reading: supervision of contrast administration, image-guided procedures, medical direction and protocol ownership, and, for mammography, the lead interpreting physician role. Each needs its own arrangement.
6. Plan the handoffs
Every coverage window has two edges. Decide who owns studies acquired in the last hour before a window closes, how overnight preliminary reports are reviewed in the morning, and how changes reach the treating team. The ACR practice parameters on communication and on emergency department coverage are useful references for these handoffs.
7. Plan the review
Agree which measures will be reported, how often, and who meets to review them. Early reviews catch routing and communication issues while they are small; later ones show whether the scope still fits your volumes.
What shapes price and start date
Neither can be quoted responsibly without a written scope. These are the factors that move them.
Price
- Volume and modality mix; cross-sectional studies take longer to read than radiographs
- Hours covered, particularly overnight and weekends
- Priority expectations and STAT response
- Preliminary or final reporting
- Specialty requirements for particular studies
- Integration work, minimum volumes and term
Start date
- State licensure for each reader
- Credentialing and privileges at the facility
- Service agreement, security review and any required business associate agreement
- Interface build and testing
- End-to-end validation and the urgent-call drill
Common questions
Should we cover every hour, or only the gaps?
Start with the gaps that affect patient care or referrers most, usually overnight emergency work or evening outpatient hours. Coverage can widen later through a scope change.
What if our volume is small?
Modality-specific or overflow patterns suit smaller volumes. Ask how minimum volumes are handled, because they often decide the real cost.
Can the scope change after go-live?
Yes. Build a review cadence into the agreement and treat changes to modalities, hours or priorities as scope amendments with their own eligibility and integration checks.
References
Primary sources
- ACR Practice Parameter for Communication of Diagnostic Imaging FindingsAmerican College of Radiology · Revised 2025
- ACR Practice Parameter for Radiologist Coverage of Imaging Performed in Hospital Emergency DepartmentsAmerican College of Radiology · Revised 2023
- When is a health care provider a business associate of another health care provider?U.S. Department of Health and Human Services
Coverage planner
Bring your scope into focus.
Modalities, priorities, hours and systems on one page. The planner prepares a brief in your browser that you can download, copy or email to the contact you choose.