Most teleradiology comparisons stall on price, which is the one number that is genuinely hard to compare across providers. These nine questions are easier to answer, they are the ones that decide whether the service works in month six, and they are the ones a provider would rather you did not ask in writing.
1. Who exactly reads our studies, and under what licence?
Ask for the answer as a process, not a number: how a reader is assigned to a modality, what happens when the assigned reader is unavailable, and how the facility can tell who read a given study. A provider that responds with a headcount instead of a process has not answered the question.
2. Is your turnaround figure a target or a guarantee?
Ask for the exact wording, and ask where the clock starts. From upload is a materially different commitment from from acquisition. HakimeRAD publishes targets measured from upload — 60–120 minutes for emergency and STAT, within 4 hours for urgent, within 24 hours for routine — and describes them as targets, because that is what they are.
3. What happens to an unexpected critical finding at 3am?
Ask who is called, by what channel, how quickly, and how the notification is recorded. If the answer is "we put it in the report", that is not a critical-findings pathway. Ask for the escalation contact arrangement in writing.
4. Where do our images and reports live, and for how long?
Ask about storage location, retention period and who can retrieve the data at the end. Retention is usually set per agreement, commonly in the range of 7–10 years, but it should be a number in your contract rather than a default somewhere in a portal.
5. Who inside your organisation can see our patient data?
Ask about role-based access and whether administrative staff can open a study. Ask about two-factor authentication for the accounts that can. Ask whether access events are logged with a timestamp.
6. What security controls do you actually operate, and are they certified?
Separate the two halves of that question. Designed controls are things you can describe — encryption in transit and at rest, role-based access, two-factor authentication, time-stamped audit logging, a defined retention period. Certification is a document. A provider who answers the first half and claims the second without producing the certificate has answered neither. HakimeRAD claims designed controls and no certification.
7. What happens when the upload fails?
This is the question that separates a working service from a demo. Ask how studies are queued when the link is down, how the facility knows whether a study was actually received, and what the fallback is for an emergency on a bad connection.
8. How do we raise a clinical concern about a report?
Ask for the process, not the promise. Who do you contact, what is the response expectation, and does a disagreement produce a documented outcome? Ask whether a second read is available on request and what it costs.
9. What does the exit look like?
Ask, before signing, how you get your data back and in what format, how much notice you must give, and what the provider retains afterwards. A provider who cannot answer this has not thought about the end of the relationship, which is usually a sign of how they will behave during it.
Two questions to ask yourself
- Is this actually a reporting problem? If the queue is empty, the constraint is elsewhere — acquisition capacity, referral volume or equipment uptime — and a reporting service will not fix it.
- Who owns the follow-up? A reporting service returns a report. Somebody at your facility still has to act on it. Name that person before you start.
HakimeRAD Teleradiology is a pre-launch service of Hakimerad Medical Consultancy. We publish no price list, we claim no certification, and we name no client facilities, because there are none to name yet.
