Remote Imaging Operations Spark Debate, Compromise Seen as Key to Patient Safety

As healthcare systems consider the growing role of remote imaging operations, concerns over patient safety and workforce readiness are fueling a complex and evolving debate. For some, remote exams offer a chance to expand access to care. For others, they raise serious questions about quality and oversight, especially when the bedside is left unattended by trained technologists.

Radiology Business recently spoke with Liana Watson, CEO of the American Registry of Radiologic Technologists (ARRT), and Melissa Pergola, CEO of the American Society of Radiologic Technologists (ASRT), about how remote operations can be implemented safely and what the future of such models might look like.

Both leaders agree that remote imaging is here to stay. The demand is growing, and the technology already exists. What’s needed now, they say, is a framework to ensure safety and accountability.

“As leaders, we have to be futurists. We are not going to stick our heads in the sand and act like this isn’t happening,” Pergola said. “And this is not new. Technology has always evolved.”

The biggest concern is clear: if a technologist is running the exam remotely, who is supporting the patient on-site?

While the ideal scenario involves a registered technologist being physically present during the exam, workforce shortages often make that impractical. Watson and Pergola are particularly worried about the current lack of training standards for bedside support in these situations. Without regulation, facilities might assign anyone to assist—from radiographers in other specialties to CNAs or administrative staff—with no standardized education.

“Best case scenario, a registered technologist is there with the patient. Unfortunately, with workforce shortages, that isn’t always possible,” Watson noted. “What’s happening right now is that the imaging practices can just bring in anybody to help—without any standardized training, without standardized testing of their knowledge.”

To address this gap, the ARRT launched a new credential in July: the Imaging Assistant, Magnetic Resonance certification. Designed to support MRI remote operations, the credential sets clear educational and competency standards for those providing bedside support during scans. Applicants must complete structured education, meet clinical competency requirements, and pass a certification exam.

“We’ve got to set a standard,” Watson said. “We know we can’t get registered MRI technologists up and running quick enough to address this issue. But what we can do is set the minimum standard for the facilities using assistants for remote operations.”

Pergola added, “If we don’t own the competence of the person in that room and keep it in the house of radiology, there will be no standard. We ultimately have the responsibility to protect our profession and our patients.”

Both leaders see the credential not just as a stopgap for staffing shortages, but as a career development opportunity for people already working in imaging departments. It could open the door to more defined career pathways and improved staff retention.

Looking ahead, Watson believes remote imaging will eventually extend across all modalities. It may even reshape how technologists are trained. ARRT has already begun exploring what that shift would require.

“Our board did some future thinking a few years ago and talked about how the future of the technologist profession may end up being split at some point into those who are really focused on the patient care part of it and those who are more focused on the technology side of it. That’s what’s happening here with remote,” she said. “There will be super techs who can do them both. They will be the ones who can put it all together.”

Pergola emphasized that remote imaging doesn’t have to be a compromise in quality. If implemented with care and oversight, it could enhance both access and safety.

“Hopefully we look back and say that we saw what was happening in clinic with people who were not competent at bedside, and that we took the steps to make sure we kept our patients safe,” she said. “I hope we can say that we kept it in the house of radiology and that we owned our service line.”