Study Reveals Widespread Misuse of Stat MRI Orders, Impacting Patient Care and Costs

New research presented at the 2025 annual meeting of the Radiological Society of North America (RSNA) has raised serious questions about the misuse of high-priority MRI orders, revealing that a significant portion of stat requisitions may be unjustified and potentially detrimental to patient care.

Stat and urgent MRI orders are designed to prioritize imaging for patients facing life-threatening or time-sensitive conditions. But findings from a Colorado-based academic-affiliated Level 1 trauma center suggest that the stat designation is frequently misapplied, leading to delays for patients in genuine need and contributing to longer hospital stays and increased costs.

“Inappropriate use of stat designation can result in delays of truly emergent cases, adversely impacting patient care,” said Lucas Eggers of the University of Colorado School of Medicine, who presented the data in a poster session. “Top priority indication for emergency imaging is meant for examinations necessary to diagnose and treat an injury or disease that is immediately threatening to life, limb or organ.”

The research was prompted by growing concern among clinical staff after noticing a rise in inpatient MRI orders labeled as stat, many of which did not meet emergency criteria. This trend led to longer wait times for imaging and a cascade of downstream effects, including delayed diagnoses, prolonged hospitalizations and inflated healthcare costs.

To better understand the extent of the problem, Eggers and colleagues reviewed all emergency and inpatient MRI orders placed during two six-month periods. Orders were grouped into five priority levels: RAD-0 (disaster/stroke/trauma), RAD-1 (ED/urgent inpatient), RAD-2 (ICU), RAD-3 (awaiting discharge), and RAD-4 (all other inpatients). Only RAD-0 and RAD-1 qualified as truly high-priority.

From a total of 6,734 MRI orders, the team randomly selected 571 stat orders (15%) for in-depth review. Two independent reviewers assessed the appropriateness of each stat designation using a standard based on imminent risk of mortality or morbidity. The results were revealing: 25.6% of stat orders were deemed inappropriate.

These inappropriate orders accounted for nearly 80,000 minutes of cumulative order-to-scan delay time. The delays not only disrupted workflow for the radiology department but also correlated with extended hospital stays and increased costs for affected patients.

Further investigation into the reasons behind the misuse uncovered two primary factors. In many cases, ordering physicians lacked a clear understanding of what qualified as stat imaging. In others, providers admitted they deliberately labeled routine imaging as stat due to frustrations with long wait times for standard MRI scheduling.

The findings point to a need for better education on imaging order protocols, as well as more efficient scheduling systems that reduce the perceived need to game the system. Without reforms, the study suggests, inappropriate stat imaging could continue to divert limited resources away from patients in true need and undermine the efficiency of emergency and inpatient care.

“Longer wait times are associated with negative outcomes in healthcare, including mortality and increased length of stay,” Eggers noted. The data, he added, underscore the importance of prioritization systems that are not only clearly defined but also consistently followed to preserve access for patients most at risk.