Teleradiology turnaround time by modality in 2026

Set the service level agreement by clinical priority before comparing teleradiology turnaround time by modality. The enforceable clock should run from last image arrival to radiologist signature, using STAT under 1 hour, urgent under 4 hours, routine under 24 hours as the tier model we publish. A modality table helps with scheduling and patient messaging, while the priority rule controls the contract.

Key facts

• STAT under 1 hour, urgent under 4 hours, routine under 24 hours is measured from last image arrival to radiologist signature.
• Measured median STAT turnaround 30 minutes is published in the dated SLA record.
• 99.4% of reports inside their SLA tier, trailing 12 months is the published compliance figure.
• AstraRad covers twelve study types through ten subspecialties.
• The panel includes 240 board certified subspecialists and runs at 600,000 reads a year.

This page is for an imaging director or radiology administrator evaluating outside reading coverage. You may need modality expectations for computed tomography, magnetic resonance imaging, ultrasound, X ray, mammography, nuclear medicine, or other study types. Those expectations should support procurement terms. They should not replace them.

AstraRad publishes STAT under 1 hour, urgent under 4 hours, routine under 24 hours, measured from last image arrival to radiologist signature. We also publish measured median STAT turnaround 30 minutes, with 99.4% of reports inside their SLA tier, trailing 12 months. AstraRad covers twelve study types through ten subspecialties with 24/7/365 on scheduled US shifts. Every read is performed inside the United States, and night reading is a dedicated, scheduled shift with a fixed rest interval before it. The panel includes 240 board certified subspecialists and runs at 600,000 reads a year.

How should buyers compare turnaround by modality?

Buyers should compare teleradiology turnaround by clinical priority first, then use modality as a planning layer. The source clock should start at last image arrival and stop at radiologist signature, matching the STAT under 1 hour, urgent under 4 hours, routine under 24 hours structure published in the dated SLA record.

Turnaround is the elapsed time from a defined start event to a defined stop event. In outside reading, the cleanest start event is last image arrival, because the radiologist cannot interpret a study that has not fully arrived. The cleanest stop event is radiologist signature, because that is when the final signed report exists.

Clinical priority is the operational urgency assigned to the study. STAT means the study needs the fastest path because clinical action may depend on it. Urgent means the study needs same shift attention, with a wider window. Routine means the study enters normal production with a defined outer limit.

A modality table can still help. Computed tomography often carries more STAT volume than screening ultrasound. Magnetic resonance imaging can need more prior comparison and subspecialty routing. Those patterns matter for staffing and expectation setting. They do not make modality the right contract clock. A chest computed tomography angiography and a routine computed tomography abdomen belong in different turnaround buckets when their clinical priority differs.

Why does modality alone fail as a speed predictor?

Modality alone fails because the modality label does not capture priority, case complexity, prior imaging needs, routing, or escalation. A source such as the American College of Radiology teleradiology guidance treats teleradiology as a clinical and operational process, not a modality list.

Modality is the acquisition category of the study. It tells you how images were obtained. It does not tell you whether the patient has suspected stroke, whether prior outside images arrived, whether contrast timing is diagnostic, or whether the study needs a fellowship trained subspecialist in a narrow area.

A single modality can carry different operational loads. A routine ankle radiograph and a cervical spine trauma radiograph may both be X ray studies. They should not carry the same response expectation if clinical priority differs. A routine magnetic resonance imaging knee and a magnetic resonance imaging brain for new neurologic deficit may share a modality label while requiring different routing.

Prior comparison also changes speed. A radiologist may need earlier imaging, surgical history, or oncology treatment dates before signing a defensible final signed report. Those steps can be invisible in a modality table. Worklist routing matters too. If the vendor routes by modality only, a complex neuroradiology study can wait behind simpler work. If the vendor routes by priority and subspecialty, the study lands in the right lane sooner.

What belongs in a real turnaround definition?

A real turnaround definition should include the clock start, clock stop, priority tier, included study states, excluded delay states, and audit method. For AstraRad tiers, the measured terms are STAT under 1 hour, urgent under 4 hours, routine under 24 hours, from last image arrival to radiologist signature.

A final signed report is the completed radiologist interpretation after signature. It is different from a preliminary note, a phone communication, or an unsigned draft. A prelim is a preliminary interpretation used in some workflows before the final signed report. An addendum is a later signed change or clarification to an existing final signed report.

Your definition should name the data path. DICOM is Digital Imaging and Communications in Medicine, the standard format used to transmit medical images. Health Level Seven is a common standard for orders, demographics, and report messages. Picture archiving and communication system, or PACS, is the image archive and viewing environment. Radiology information system, or RIS, is the order, status, and reporting workflow system.

Put the timestamps in writing. Require last image arrival, study available to the worklist, assignment, dictation start if tracked, signature, and report delivery back to your system. Also define which delays pause the clock. Missing images, missing orders, wrong accession data, or unreadable priors can create delay states. A service level agreement is the written operational promise that states the tier, the clock, the measurement window, and the reporting method.

How can an imaging director ask for proof?

Ask for proof by requiring dated tier performance, timestamp methodology, and the exact measurement window before signature. AstraRad publishes 99.4% of reports inside their SLA tier, trailing 12 months, and measured median STAT turnaround 30 minutes, measured from last image arrival to radiologist signature.

Proof is a method. Start with the tier definitions. Confirm that STAT, urgent, and routine use the same start and stop points across study types. Then ask for median performance and tail performance by tier. Median tells you the typical experience. Tail performance tells you how often the vendor misses your operational promise when volume, staffing, or routing gets stressed.

Ask how the vendor reconciles timestamps. The RIS may show order time. PACS may show image receipt. The reporting platform may show signature time. Those clocks can disagree if interfaces lag or if a study is corrected after arrival. Your vendor should state which system is authoritative for each timestamp. The vendor should also explain how it treats cancelled studies, duplicate accessions, missing clinical history, and studies sent before completion. You should be able to audit a sample. The audit should match contract terms, not a sales dashboard. If procurement asks how the number was measured, you need an answer that survives the room. We build our proof around the dated SLA source, then keep the operational language identical in the contract review.

For a deeper procurement checklist, compare this approach with our guide to verifying teleradiology vendor claims.

When does a modality table do better?

A modality table does better when you need a simple planning tool for budget, staffing, and patient communication. An industry typical pricing discussion, separate from AstraRad pricing, often groups studies by modality, as shown in market pricing resources dated 2026.

That simplicity has value. Your front desk can tell a patient that routine outpatient reports usually follow a general time band. Your finance group can model expected volume by computed tomography, magnetic resonance imaging, ultrasound, mammography, X ray, and nuclear medicine. Your lead technologist can see which modalities create the busiest hours.

The weak point appears when the table becomes the service level agreement. A modality line can hide priority. It can also hide subspecialty routing. If every magnetic resonance imaging study carries the same promise, the agreement may treat routine knee imaging like an urgent brain study. If every computed tomography study carries the same promise, it may miss the difference between a low acuity follow up and a critical vascular question.

Use modality tables for planning. Use priority tiers for enforcement. That gives you a practical operating model without giving up the clinical logic. The table can say which studies usually enter routine, urgent, or STAT lanes. The agreement should still say which clock controls when the priority changes.

How does AstraRad handle turnaround across study types?

AstraRad handles turnaround across study types with priority tiering, subspecialty routing, and scheduled United States coverage. The published operating terms cover twelve study types, ten subspecialties, and 24/7/365 on scheduled US shifts, with the clock measured from last image arrival to radiologist signature.

We do not reduce the promise to a modality table. A subspecialist signs the final signed report, and routing follows the clinical need of the study. That matters when a modality label is too broad to decide the worklist path. A neuroradiology magnetic resonance imaging study, a musculoskeletal magnetic resonance imaging study, and an abdominal magnetic resonance imaging study should not be treated as interchangeable work.

Coverage is the staffed reading capacity available for assigned studies. For nights, our coverage uses dedicated, scheduled shifts. Every read is performed inside the United States. Night reading has a fixed rest interval before it, which keeps the night lane separate from an afterthought coverage model.

The measured terms stay plain. STAT under 1 hour, urgent under 4 hours, routine under 24 hours. Measured median STAT turnaround 30 minutes. 99.4% of reports inside their SLA tier, trailing 12 months. Those figures live in one dated source so your diligence team sees the same language sales, operations, and contracting see.

If you need commercial terms after the operational review, Request a consult.

How should buyers write modality expectations without weakening the SLA?

Write modality expectations as an operating appendix under a priority based SLA. The controlling term should remain the priority clock, using the STAT under 1 hour, urgent under 4 hours, routine under 24 hours model measured from last image arrival to radiologist signature.

The appendix can list each modality and the usual priority mix. For example, routine screening studies may usually enter the routine lane. Certain emergency department protocols may usually enter the STAT lane. Follow up oncology imaging may enter routine or urgent depending on the ordering indication and local workflow. This gives staff a shared expectation without making modality the only rule.

The agreement should also define escalation. If a referring clinician changes the priority, the clock should follow the documented priority change from the agreed timestamp. If a study arrives with missing images or a broken order, the agreement should define the delay state. If the study needs a specific subspecialty, the routing rule should state how assignment occurs.

Do not bury these rules in a sales exhibit. Put them where operations, legal, and procurement can enforce them. Your modality appendix should help schedulers and site managers. Your SLA should protect patient care and report delivery. Those are different jobs, and the document should make that separation clear.

For background on how the workflow fits together, use our step by step teleradiology explainer.

What should go on the vendor scorecard before signature?

Your scorecard should test the contract clock, the proof method, the subspecialty match, compliance posture, coverage model, and escalation rules. AstraRad publishes 24/7/365 on scheduled US shifts, twelve study types, and ten subspecialties as part of the operating record.

A scorecard is the procurement tool that turns claims into contract checks. Keep it short enough for the review meeting and specific enough for legal review. The first line should ask for the start event and stop event. The second should ask for performance by tier, with the measurement window stated. The third should ask how exceptions are handled.

Include clinical fit. The vendor should show how studies reach the right subspecialist. The scorecard should also ask how the vendor handles prior images, addenda, critical result communication, and discrepancy review. If a vendor reports a discrepancy rate, require the denominator in writing.

Include compliance. AstraRad is HIPAA aligned, operates as a business associate under a signed BAA, is a GDPR processor under a DPA, and is DICOM conformant. Your information security review should also check access controls, audit trails, and interface handling. The American College of Radiology Practice Parameters and Technical Standards give useful context for professional expectations.

Use pricing as its own line. AstraRad uses per report pricing, no minimums, no ceilings, no surge premium. For buyer context, our pricing and turnaround page keeps the model tied to the same SLA language.