Extending and embracing MRI technologist expertise through remote scanning has emerged as one way to relieve staffing constraints, increase imaging equipment uptime, and prevent delays for complex scans.
Despite its promise, remote scanning has leaders in the field cautious about patient safety, imaging quality, and personnel development. However, the U.S. Centers for Medicare and Medicaid Services (CMS) has approved MRI standards inclusive of remote scanning guidelines, and early adopters are talking about what's working and not working well.
Could remote MRI scanning become a common strategy for hospital systems and outpatient imaging centers? For this AuntMinnie special edition, remote scanning practice leaders break down the current state of the remote MRI scanning trend in the U.S. and share what they've learned.
Extending and embracing MRI technologist expertise through remote scanning has emerged as one way to relieve staffing constraints, increase imaging equipment uptime, and prevent delays for complex scans.
Despite its promise, remote scanning has leaders in the field cautious about patient safety, imaging quality, and personnel development. However, the U.S. Centers for Medicare and Medicaid Services (CMS) has approved MRI standards inclusive of remote scanning guidelines, and early adopters are talking about what's working and not working well.
Could remote MRI scanning become a common strategy for hospital systems and outpatient imaging centers? For this AuntMinnie special edition, remote scanning practice leaders break down the current state of the remote MRI scanning trend in the U.S. and share what they've learned.
Before zeroing in on a remote scanning initiative for MRI, radiology administrators and hospital executives must first understand the key performance indicators (KPIs) that would determine the need for and measure the success of remote scanning.
These KPIs include imaging equipment utilization, turnaround time, patient access, and quality metrics, explained Amy Peronace, vice president of operations for RemoteRadTech, a staffing firm operating a remote hub command center in Miami, FL. The firm contracts with organizations such as hospitals, imaging centers, and physician offices that need staffing support.
Idle imaging equipment
"If one MR [scanner] is fully staffed 12 hours a day and the other sits idle and empty because they don't have enough staff, administrators will look for ways to increase their equipment utilization time," Peronace told AuntMinnie. "They are being pressured to fill schedules, increase access, expand hours, and get more patients through. They are also looking at the quality of their studies and their recall rate."
Amy Peronace, RemoteRadTech.
Logistically, remote scanning can be established anywhere, but it depends on the department, buy-in from onsite staff, and the support they have, Peronace said.
Remote MRI scanning involves selecting a remote scanning platform to be operated by a certified technologist who has secure access to visualize the MR control panel, Peronace explained. Remote MRI technologists perform or oversee scans from a command center, and others may be scanning from a home office.
Pressure points
One of the pressure points with adopting remote MRI scanning is defining roles and responsibilities between the physical staff onsite and the remote technologist.
"Each center will be different," Peronace said. "And there are gray lines as to who is responsible for that patient -- for allowing them into [the most hazardous] Zone 4. As the registered technologist, it is ultimately our responsibility for the patient’s safety and who is allowed into Zone 4.”
Recognizing these challenges and other opportunities, the AHRA (Association for Medical Imaging Management) organized a Remote Scanning Taskforce of medical imaging association leaders to create an MR guidance paper outlining key considerations.
The AHRA posed eight specific questions related to developing formal workflow policies to help guide organizations prospectively.
Communication workflows: When and how are remote technologists notified of patient scans?
Patient safety: Who is responsible for the patient screening form if there is an onsite MR technologist?
Patient safety: How is the screening form shared with the remote technologist?
Contrast injections: How is contrast injection timing communicated, via phone or chat?
Contrast injections: If the remote technologist is an external employee, are they familiar with the contrast policies of your facility?
Image quality: Who is responsible for verifying that the patient exam is complete and all images are acquired?
Image quality: Do radiologists need to be involved to verify if using advanced imaging?
Exam protocol: Under supervision of the radiologist, who decides which protocol to use?
While remote scanning vendors offer training on the software, the formal remote scanning workflow and training policy will ultimately need to be decided by the healthcare organization implementing the program, the AHRA advised.
Connected imaging teams
Jason Newmark, AHRA.
The AHRA has been surveying organizations to learn about how remote scanning is practiced and develop rules that will vary by modality.
Remote scanning is rapidly emerging as a key innovation in medical imaging in use in integrated delivery networks, community hospitals, as well as independent diagnostic testing facilities and physician-owned outpatient centers, explained AHRA Executive Director Jason Newmark.
The technology can help increase access to services, support staff engagement and coverage, and enhance workflow efficiency, he said. The key is to implement safe processes and ensure well-trained and expert staff -- employed and/or contracted, Newmark told AuntMinnie.
The AHRA surveyed its membership in 2025, gathering responses from 179 imaging administrators, 42% of whom were from community hospitals and hospital networks and almost 10% based at critical access locations. About 18% of the overall AHRA survey cohort reported they were engaged in remote scanning, Newmark said.
The AHRA's survey and others are beginning to lift the veil on remote scanning in practice in the U.S., although it is noteworthy that the U.S. hospital universe is quite large, at just over 6,000 hospitals.
An 2025 AHRA survey revealed that adoption of remote scanning is growing but still limited. Imaging departments are using remote scanning technologists to perform complex exams and for over-the-shoulder help, for example.AHRA
Results shared with AuntMinnie show that MRI is the imaging modality most practiced remotely. However, the exact number of remote MRI scanning sites is still largely unknown.
Standards and accreditation
CMS-deemed accreditation organization (AO) Intersocietal Accreditation Commission (IAC), one of four such accrediting bodies for advanced diagnostic imaging, posted new MR accreditation standards in April 2025. IAC's 34-page document highlights shared and solo responsibilities of the local technologist and remote technologist/physician.
IAC also defines key distinctions about remote scanning facilities, such as the following:
"Local facility" (where the imaged patient is physically located)
"Remote facility" (the location participating in image acquisition, where the patient is not physically located)
"Passive remote scanning" (evaluation of scans already completed or postprocessing duties, does not affect the scanner at the local facility)
"Active remote scanning" (which means participation in the operation of another scanner whereby a patient is involved, does affect the scanner at the local facility)
RadSite, another CMS-deemed AO, has identified several hundred remote scanning locations and at least 500 remote scanning technologists, according to the Maryland-based firm's president and CEO, Garry Carneal.
Garry Carneal, RadSite.
Over the past five years, RadSite has also developed remote MRI and CT standards that encompass administrative, operational, and clinical and quality requirements.
"RadSite’s accreditation program was established in part to assist imaging providers in addressing the shortage of MRI technologists and also because of regulatory complaints," Carneal told AuntMinnie.
Accreditation involves virtual and onsite audits to confirm compliance, he explained, also predicting that private payers will begin to mandate accreditation and compliance with the standards.
"If remote scanning is conducted in accordance with best practices and performed by a technologist who specializes in the relevant modality and specialty exam, it is possible to achieve a high-quality examination," Carneal continued. Remote scanning programs can also increase access for patients.
"There is a lot of potential, but there's also a lot of danger because if the standards are not followed, there are a number of different ways where patients could be harmed or get less than an optimal exam," he cautioned.
Caseload policy need
RadSite is among the AOs discussing this issue with CMS over the past several years. Carneal said that most state regulatory complaints have involved caseloads -- remote technologists running up to six MRI scans at one time.
"I've seen the stress of a remote scanning technologist when you move from two to even three simultaneous MRI scans concurrently," he told AuntMinnie, recommending that sites develop a policy that limits caseload to two or possibly three cases. In contrast, RadSite requires that remote scanning technologists only run one CT scan at a time.
"The regulatory framework for MRI is significantly looser than the regulatory framework for modalities that involve ionizing radiation," Carneal noted. It's an issue echoed by American Registry of Radiologic Technologists (ARRT) CEO and 40-year radiologic technologist (RT) veteran Liana Watson, who added that only eight states currently regulate who can perform MRI.
Liana Watson, ARRT.
"It was natural to ramp up remote scanning," Watson told AuntMinnie. "The profession became concerned about who was going to take care of the patient in that MRI environment because it can quickly become a very dangerous environment."
In-suite partnership
This year, the ARRT pivoted to establish education standards for in-suite MRI personnel, a new role on the RT career ladder (imaging assistant magnetic resonance [I.A. MR]), and a credential.
"Transportation aides and general assistance medical imaging personnel have worked in our departments for years, but we specifically selected the MRI environment to be the first for this credential because of the emergent need with remote scanning," Watson said.
The imaging assistant should serve as the certified MRI technologist's onsite partner to make sure there is a safe environment for that procedure to be performed, she added.
"What we focus on is MRI safety -- these individuals showing competency at an MRI Level 2 safety, which is required by all MRI facility accreditors," Watson continued. "We wanted to meet that mark and, as a profession, legitimize the role of the MR imaging assistant on the medical imaging team."
The ARRT envisions the credentialed I.A. (MR) assisting the ARRT MR-certified technologist in preparing the patient for the exam, positioning the patient, and assisting throughout the pre-MRI screening form questionnaire. The ARRT expects to hold its first I.A. (MR) credentialing exam in the fall of 2026.
Caution and care
Importantly, "the MRI-credentialed technologist is in charge of the procedure, not the imaging assistant," Watson emphasized. "Remote scanning technology cannot replace qualified professionals in medical imaging -- especially in high-risk environments like MRI, where precision, safety, and patient care intersect daily."
"CMS made it very clear and we put it in our standards that the in-suite aide cannot operate the system," Carneal noted.
Administering contrast also requires someone within the scope of licensing. Active clinical leadership is also key.
"At the end of the day, you have to have that Level 2 person there, with eyes on the patient, physically responsible for their safety and being able to respond in an emergency,” Peronace added.
Moreover, remote MRI scanning isn't for every MRI technologist, Peronace cautioned.
"It takes a different level of concentration; it's just a different mental load,” Peronace said. “Multitasking isn't for everyone."
From a patient safety perspective, the Joint Commission has no standards that would prohibit remote MRI scanning as a care delivery model. As organizations continue to evolve care models to include virtual, remote, and telehealth, there is complexity in those models, the Joint Commission said in an email to AuntMinnie. Regardless, the principles of patient and staff safety remain constant and true whether an organization uses a remote or nonremote model, the Joint Commission said.
For hospital and critical access hospital accreditation programs, requirements for imaging safety appear in the Joint Commission’s new National Performance Goal (NPG) 13, effective January 1, 2026. NPG 13 signals imaging safety as essential to patient safety and quality improvement, the Joint Commission said.
The American College of Radiology (ACR) has supported the use of remote scanning, as long as it is conducted in a manner that promotes patient safety, image quality, and personnel development. The organization issued a position statement that included considerations for personnel and personnel development, the remote scanning technology, program oversight, physician supervision, and contrast safety management.
In response to comments, concerns, and opportunities, ACR in March 2025 issued an update suggesting the medical imaging community has not reached consensus on the rules of remote scanning on the whole, especially when it comes to remote technologists supervising only one scan at a time.
Imaging house divided
"Some respondents expressed that remote technologists could reasonably support more than one scan at a time, while others reinforced the position that the remote technologist should focus on one scan at a time for quality and safety purposes," the ACR noted.
While the ACR's accreditation criteria allow for remote scanning, the organization also pointed out the importance of defining a qualified onsite operator, requirements for remote video and audio monitoring, policies and protocols, and patient notification requirements.
The ongoing shortage of technologists has been a difficult challenge to overcome in radiology. Hospitals, imaging centers, and other firms that employ expert, specialized remote scanning technologists could be a potential lifeline for other organizations that want to prevent idle equipment, provide complex scans, and enable greater patient access.