Meeting the Demand for Faster Imaging: How to Bridge the Gap Between Resources & Radiology Workflow

By: Raif Erim, Kimberly Love, Derek Hunley, and Briauna Driggers

​Radiology plays a critical role in modern healthcare, but systemic inefficiencies continue to delay patient care. Workforce shortages, scheduling barriers, and administrative bottlenecks all lead to patient throughput delays. This article explores key factors impacting radiology flow and potential solutions.

Key Factors Affecting Radiology Throughput

1. Access to Specialists & Referral Pathways

Timely access to radiology services depends on efficient referral pathways and the availability of specialized providers. However, growing radiologist shortages have led to extended waiting times with some patients waiting months for necessary imaging studies [1]. As we experience an accelerating issue in the United States related to the increasing demand and growing radiologist shortage, other countries are facing similar challenges with access and throughput.

​In the United Kingdom, patients face extensive waits for specialist consultations with some resorting to private healthcare to circumvent the NHS's overloaded system. For instance, in July 2024, over 407,000 referrals had no available outpatient slots marking a 78% increase since 2018. This shortage is particularly severe in orthopedics, cardiology, and diagnostic imaging, prompting general practitioners to describe the situation as a "referrals black hole" [9].
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To address these challenges, Australia has implemented the widespread adoption of the digital medical referral platform, HealthLink, to streamline communication between primary care providers and specialists [10].

2. Insurance Authorization Challenges

Prior authorization requirements also impose significant delays in patient access to imaging. Many insurers require pre-approval for advanced imaging services such as MRIs and CT scans, creating administrative burdens that result in prolonged wait times [4]. Studies indicate that these delays contribute to diagnostic and treatment postponements, which can affect patient outcomes [3].
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One way to mitigate these delays is through streamlined prior authorization processes, such as automated approvals for routine imaging based on clinical decision support systems. Additionally, legislative efforts to reduce excessive prior authorization requirements could help improve timely access to imaging services. Collaborations between insurers and healthcare providers to establish standardized protocols may also reduce administrative burdens and expedite approvals which ultimately improve patient care efficiency.

3. Scheduling Bottlenecks

Even after obtaining a referral and insurance approval, patients frequently encounter scheduling delays due to limited appointment availability and inefficient scheduling systems [2]. In the United States, scheduling delays significantly hinder patient access to specialized care. A 2024 report highlighted that 17% of patients waited one to three months for a doctor's appointment, reflecting a growing trend of prolonged wait times [2].

To address these delays, healthcare providers can implement more advanced scheduling algorithms that prioritize urgent cases and distribute appointment slots more efficiently across available facilities. Additionally, leveraging artificial intelligence and automated scheduling tools can reduce administrative burdens and optimize patient flow. Some healthcare systems have also adopted centralized scheduling hubs, which coordinate across multiple imaging centers to maximize appointment availability and minimize wait times [11].
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Additionally, patient no-shows and last-minute cancellations further exacerbate scheduling inefficiencies, often leaving valuable appointment slots unused. High no-show rates disrupt patient flow and reduce overall imaging throughput. To combat this, many organizations are leveraging predictive analytics to identify patients at high risk of missing appointments. They are also implementing targeted interventions, such as automated text/email reminders and waitlist management systems, to fill vacated slots quickly. An MGMA Stat poll reported organizations that utilized automated appointment reminders saw improved adherence and operational efficiency [13].

4. Imaging Equipment and Technologist Availability

While advances in imaging technology have improved scan times, a shortage of technologists continues to hinder the usage of this technology [5]. Without sufficiently trained personnel to operate advanced imaging systems, facilities may struggle to fully utilize newer technologies, leading to the underuse of high-efficiency scanners and extended patient waiting times.
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Some facilities have explored remote imaging solutions to alleviate staffing shortages by allowing technologists to operate multiple machines from a centralized [5]. These systems leverage AI-assisted imaging protocols and remote operation software to enable real-time adjustments and communication between on-site staff and remote technologists. However, certain imaging procedures still require in-person adjustments limiting the applicability of remote solutions [5]. For example, modalities such as mammography and fluoroscopy require hands-on patient positioning, making remote operations infeasible in these cases. Additionally, potential concerns have been raised related to patient safety and appropriate protocols when considering remote or centralized technologist solutions. While there is certainly a business case for improved efficiency and reduction in operating costs, the patient's safety and experience must not be compromised when exploring this type of solution.

5. Report Turnaround Times & Radiologist Shortages

Reducing scan times does not automatically translate to faster diagnosis if radiologist shortages persist. The American College of Radiology (ACR) reports that rising imaging demand has outpaced the number of practicing radiologists leading to longer report turnaround times [1]. This issue not only affects patient outcomes, but it also increases the burden on existing radiologists leading to burnout and reduced efficiency.
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Potential solutions include leveraging AI for image analysis and redistributing workload among radiology teams [6]. AI can assist by prioritizing urgent cases, automating routine image assessments, and flagging potential abnormalities for radiologists to review more efficiently. Additionally, expanding teleradiology services allows facilities to access radiologists across different time zones, helping alleviate regional shortages and reducing turnaround times.

Balancing Efficiency, Costs, and Patient Safety

Ultimately, efforts to streamline radiology throughput must be balanced with quality control and patient safety measures. While AI-assisted diagnostic tools and workflow optimizations can enhance efficiency, concerns regarding the overutilization of imaging services and diagnostic accuracy persist [7,8].

Optimizing radiology throughput requires a multifaceted approach, including policy changes to streamline referrals, scheduling automation, workforce expansion, and (most likely) AI integration of some kind. Addressing these challenges can improve patient access to timely and accurate diagnostic services, ultimately enhancing overall healthcare efficiency. 
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In addition to clinical and operational considerations, regulatory and reimbursement pressures increasingly shape how radiology departments allocate resources and implement new technologies. Shifts in CMS policies, such as site-neutral payments, the Multiple Procedure Payment Reduction (MPPR), and evolving quality reporting requirements, can significantly impact imaging margins and long-term planning [12]. Staying aligned with these policy trends is crucial to sustaining throughput improvements while maintaining financial viability.

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​At Regents Health Resources, we offer strategic consulting services to enhance radiology operations. By addressing workforce shortages, scheduling barriers, and administrative obstacles, we help improve patient access to timely and accurate diagnostic services. 

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