What does emergency teleradiology cover?
The short answer
Emergency teleradiology covers the CT, X-ray, ultrasound and MRI studies the ED orders when no radiologist is on site. Orders arrive by HL7, images route to the reading group, and a radiologist licensed in your state and approved by your medical staff reads them and sends the report back into your system. For the ED, the value is speed on STAT and stroke studies and a direct phone call for every critical finding.
OP-23: ED arrival to stroke CT interpretation
CMS OQR
Door-to-CT start goal
AHA Target: Stroke
Door-to-needle goal
AHA Target: Stroke
TeleRads critical call standard
TeleRads
Each dial shows a published target in minutes on a 60-minute clock face. It is not performance data.
The first three figures come from CMS (Hospital OQR, OP-23) and the American Heart Association’s Target: Stroke interval goals (AHA, 2019). Stroke has its own guide: emergency and stroke teleradiology. This page is about the rest of the ED night.
What does the overnight ED imaging mix look like?
A typical overnight emergency book is CT-heavy by study count. In general terms, roughly half of overnight ED studies are CT, and plain film makes up most of the rest by volume; ultrasound and MRI are a smaller share and vary most by hospital.
CT head and cervical spine
Typical: falls, head injury, altered mental status, stroke alerts.
Deciding: bleed or fracture; stroke treatment; transfer.
CT angiography
Typical: stroke (head and neck), pulmonary embolism, aortic syndromes.
Deciding: thrombectomy transfer; anticoagulation; surgery.
CT abdomen and pelvis
Typical: abdominal pain, trauma, suspected appendicitis, obstruction.
Deciding: surgery consult, admit or discharge.
Plain film
Typical: chest X-ray, extremity and spine trauma, line and tube checks.
Deciding: pneumonia, fracture, tube position.
Ultrasound and MRI
Ultrasound: ectopic pregnancy, gallbladder, testicular or ovarian torsion, DVT. MRI: cord compression, selected stroke protocols.
General pattern; varies by hospital.
Two practical points follow. First, CT carries most of the reading time and most of the critical findings, so coverage has to be sized for the CT volume, not the total study count. Second, plain films arrive in bursts; a reader who batches them behind CT can quietly slow ED discharges.
What is a good ED radiology turnaround time?
Outside stroke, there is no national number. STAT and ED studies are commonly targeted well inside the ED visit, because the read decides admission, transfer or discharge. Stroke has measured windows: interpretation within 45 minutes of ED arrival (CMS OP-23), inside an AHA goal of starting the scan within 25 minutes and treatment within 60 (AHA Target: Stroke Phase III). Full detail is in radiology turnaround time benchmarks and stroke imaging turnaround and OP-23.
- Stroke
45 minutes from arrival
Interpretation within 45 minutes of ED arrival for eligible patients (OP-23). The read sits between the scan and the treatment decision.
- Critical results
A call clock
Not a report clock. Category 1 findings are called within minutes, under NPSG.02.03.01 and your list.
- Trauma and STAT
Well inside the visit
Write a number for each priority into the agreement.
- Routine ED studies
Inside the visit
Behind stroke, trauma and STAT in the worklist.
Measure from all images complete on the worklist to the signed report, report medians plus the share inside target, and split by hour: overnight turnaround behaves differently from evening.
Stroke, OP-23 and critical calls
The stroke read
Timed from ED arrival under OP-23. The study jumps the worklist and the read answers the question that drives treatment: is there a bleed?
The critical call
How a bleed, a dissection or a torsion reaches the physician who can act: the radiologist calls directly, and the receiver reads the finding back.
For the ED, these two calls matter more than any average. Give your teleradiology group your radiology critical results list before go-live, and ask to see every critical call on a monthly report with the time from read to call. The process itself is covered in critical results communication.
What does the ED need from a teleradiology vendor?
| Model | Overnight prelimsFast first answer; your day group signs the final | Overnight signed finals Ask for thisThe report of record at the time of the read | Day group on call from homeYour own radiologists, after a full day |
|---|---|---|---|
| Signed report in the chart overnight | No | Yes | Yes |
| Morning re-read by your day group | Yes, every prelim | None | None |
| Prelim-to-final discrepancy loop | Yes, someone must catch it | None | None |
| Stroke studies read first | Ask | Ask for it in writing | Depends on the night |
| Critical calls with read-back | Ask | Ask for a time in writing | Varies by reader |
| Your day group rested for the morning | Yes | Yes | No |
| Get my free coverage plan |
None of these is wrong for every hospital; teaching hospitals often run on prelims by design. But for most community and rural EDs, signed finals overnight remove the morning re-read and the discrepancy loop. Every option is compared in after-hours radiology coverage.
A buyer checklist for ED teleradiology
- 01
Finals or prelims?
For every modality and every hour you would cover.
- 02
Turnaround by priority
Stroke, trauma, STAT and routine ED, each with a number and a clock.
- 03
Critical calls
Your list, a time limit, read-back and a monthly call log.
- 04
Reachability
Can your ED physician call the reading radiologist back about a read?
- 05
Backup
Who reads when the scheduled radiologist is unavailable, and are they credentialed already?
- 06
Credentialing
Licensed in your state and approved by your medical staff before the first read.
- 07
Integration
HL7 orders, image routing and reports back into your system, with nothing to install.
- 08
Pricing
Per study or per wRVU, and whether STAT, after-hours or weekend reads cost extra.
- 09
Morning handoff
What your day group receives at 7 AM.
The contract terms behind each item are in the teleradiology contract checklist.
How TeleRads covers the ED
Stroke and trauma first
Stroke, trauma and ED reads are inside every coverage block, and stroke and trauma studies go to the top of the worklist the moment they land on our PACS.
Criticals called in 15 minutes
Critical results are called to your ED within 15 minutes, with read-back, from your critical results list. The radiologist stays available for your ED physicians to call back about a read.
Signed finals
Every report is a signed final; we read finals only, never preliminaries.
A named backup
A named backup, already credentialed at your hospital, is on every night.
7 AM handoff
A handoff note goes to your day group at 7 AM.
Nothing to install
Orders come to us by HL7 and images by secure routing to our PACS.
No surcharges
One monthly price, per study or per wRVU, with no STAT, after-hours or weekend surcharges.
Monthly scorecard
Turnaround and every critical call, each month.
Coverage runs overnight (typically 10 PM to 7 AM), evenings, weekends and holidays, daytime overflow or 24/7. Most hospitals are live in 30 days; your medical staff calendar sets the final date.
Questions
What is emergency department teleradiology?
Remote radiologist coverage for the imaging your emergency department orders, most often overnight, on weekends and on holidays. Studies route to a radiologist licensed in your state and approved by your medical staff, who reads them and sends the report back into your system.
What is a good ED radiology turnaround time?
Outside stroke there is no national standard. STAT and ED studies are commonly targeted well inside the ED visit, and stroke imaging has measured windows: interpretation within 45 minutes of ED arrival under CMS OP-23. Write a target for each priority into your agreement and report medians plus the share inside target.
What imaging does an ED order overnight?
Mostly CT and plain film. In general terms, about half of overnight ED studies are CT, including head and cervical spine, CT angiography for stroke and pulmonary embolism, and abdomen and pelvis, with plain film making up most of the rest and a smaller share of ultrasound and MRI.
Should overnight ED reads be preliminary or final?
For most community and rural hospitals, signed finals overnight remove the morning re-read and the prelim-to-final discrepancy loop. Teaching hospitals often use resident prelims by design. Ask any vendor which they provide for every modality and hour.
How are critical findings communicated to the ED?
By a direct phone call from the radiologist to the ED physician or responsible caregiver, with read-back, following the hospital’s critical results list and documented with the receiver’s name, role and the time. TeleRads calls critical results within 15 minutes.
How is ED teleradiology different from stroke teleradiology?
Stroke teleradiology is one lane inside ED coverage, built around the OP-23 and door-to-needle clocks. ED teleradiology covers the whole night: trauma, abdominal pain, chest pain, line checks and every other study the ED orders.
Does TeleRads charge extra for STAT or after-hours ED reads?
No. Pricing is one monthly price, per study or per wRVU, with no STAT, after-hours or weekend surcharges. Your exact price comes in your free coverage plan.