Imaging interpretation turnaround times increase 27% in 1 year

Medical imaging interpretation turnaround times leapt by 27% from 2023 to 2024, signaling continued struggles with staffing and bottlenecks in radiology. 

That’s according to new research from the Neiman Health Policy Institute, published Tuesday by the Journal of the American College of Radiology. The finding is based on an analysis of nearly 3 million office/hospital outpatient Medicare claims and is an update to previous Neiman research released in March.

When tracing back to 2014, imaging interpretation turnaround times have increased approximately 177%, from 2 hours and 11 minutes, up to 6 hours and 1 minute in 2024. About 92% of that change occurred between 2022-2024. 

“It's striking is that these increases were already measurable well before radiologists began anecdotally reporting the problem in 2024,” study co-author Christoph Wald, MD, a Mayo Clinic professor and chair of the ACR board, said in a statement Aug. 4.

The study utilized a 5% representative sample of fee-for-service Medicare claims for office- or hospital-based outpatient imaging. It included technical claims covering the image acquisition, along with matched professional claims for the subsequent interpretation. Turnaround times were defined as the period between when a scan is performed and a radiologist reads the images. March’s study previously found that TATs leapt 113% between 2014 and 2023, with 87% of the increase occurring in the last two years. Study authors recently updated their findings after Medicare released new data.

Study senior author Eric Christensen, PhD, research director at the institute, noted that the continued turnaround time increase in 2024 signals this is a “genuine, persistent trend.” TATs had generally remained flat through 2021 and then leapt “sharply” each year since then. While the 27% increase was less than what was seen in 2023 (60%), this likely reflects a “comparison to an already elevated rate,” he added. 

Most imaging studies were interpreted on the same day—at nearly 97% over the 10-year period, the study found. However, the share interpreted 1 or more calendar days after imaging acquisition increased fourfold, from 1.97% in 2014 to 7.39% in 2024. Similarly, the share of exams interpreted 7 or more calendar days after acquisition increased from 0.41% in 2014 up to 8.7% in 2024. 

Separated by modality, ultrasound saw the biggest turnaround time increase from 2023 to 2024, up 49%. Radiography came next at 35%, followed by CT (12%) and MR (5%). While 2024 increases were smallest for these two advanced modalities, their increases were the largest when tracing back to 2014 for computed tomography (up 381%) and MR (278%) and smallest for radiography (126%). 

“Why the trends differ by modality is unknown,” added Wald. “It is possible that practice leaders may have made operational adjustments to mitigate increases and prioritized CT and MR. But even so, turnaround times continued to climb, suggesting that adjustments weren’t sufficient to overcome the underlying trend.”

Those involved in the analysis believe their work echoes ongoing concerns about the radiologist workforce pipeline and its ability to meet patient demand. 

“With radiologists already in short supply amidst rising imaging utilization, our results amplify existing concerns about the ability of the current and future radiologist workforce to provide patients with timely results without a solution to dampen growing imaging demand,” said study co-author Greg Nicola, MD, with Hackensack Radiology Group in New Jersey, and vice chair of ACR’s board. 

Read more, including potential study limitations, in JACR.